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Fonseca AM, Dos Santos RG, de Medeiros LS, Veiga TAM, Cassas F, Bruniera CP, Rossi GN, Bouso JC, Hallak JEC, Santos FP, Paranhos BAPB, Yonamine M, Rodrigues E. Long-term ayahuasca use is associated with preserved global cognitive function and improved memory: a cross-sectional study with ritual users. Eur Arch Psychiatry Clin Neurosci 2024:10.1007/s00406-024-01817-9. [PMID: 38780800 DOI: 10.1007/s00406-024-01817-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 04/19/2024] [Indexed: 05/25/2024]
Abstract
Although several studies have been conducted to elucidate the relationship between psychedelic consumption and cognition, few have focused on understanding the long-term use influence of these substances on these variables, especially in ritualistic contexts. To verify the influence of ritualistic ayahuasca consumption on the cognition of experienced ayahuasca religious users (> 20 years) and beginners (< 3 years), which participated in rituals of the Centro Luz Divina (CLD), a Santo Daime church in Brazil. Observational, descriptive, and cross-sectional study was carried out in which 48 people participated divided into three groups: (a) experienced ayahuasca users (n = 16), (b) beginner ayahuasca users (n = 16) and (c) control group (n = 16). All groups were matched by sex, age, and education and contained 8 women and 8 men. Cognition was assessed with the WASI (intelligence quotient), Digit Span (verbal working memory), Corsi Block-Tapping Task (visuospatial-related and working memory), Rey-Osterrieth Complex Figure test (visual perception, immediate memory), and Wisconsin Card Sorting and Five Digit Test (executive functions). Groups were homogenous in terms of sociodemographic characteristics, with participants presenting average intellectual performance. There was no evidence of cognitive decline amongst ayahuasca users. The experienced group showed higher scores compared to the less experienced group in the Digit Span and Corsi Block-Tapping tasks, which assess working verbal and visuospatial memories respectively. We confirmed the botanical identities of Psychotria viridis and Banisteriopsis caapi and the presence of the alkaloids both in the plants and in the brew. Short and long-term ayahuasca consumption does not seem to alter human cognition, while long-term use seems to be associated with improvements in aspects of working memory when compared with short-term use.
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Affiliation(s)
- Arilton Martins Fonseca
- Centre for Ethnobotanical and Ethnopharmacological Studies, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Rafael Guimarães Dos Santos
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.
- National Institute of Science and Technology, Translational Medicine, Ribeirão Preto, São Paulo, Brazil.
| | - Lívia Soman de Medeiros
- Laboratório de Química Bio-Orgânica Otto Richard Gottlieb (LaBiORG), Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Thiago André Moura Veiga
- Laboratório de Química Bio-Orgânica Otto Richard Gottlieb (LaBiORG), Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Fernando Cassas
- Laboratório de Química Bio-Orgânica Otto Richard Gottlieb (LaBiORG), Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Carla Poleselli Bruniera
- Herbário da Universidade Federal de São Paulo (HUFSP), Campus Diadema (UNIFESP), São Paulo, Brazil
| | - Giordano Novak Rossi
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - José Carlos Bouso
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
- International Center for Ethnobotanical Education, Research, and Service (ICEERS), Barcelona, Spain
- Department of Psychology and Research Center for Behavior Assessment (CRAMC), Universitat Rovira I Virgili, Tarragona, Spain
| | - Jaime E Cecílio Hallak
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
- National Institute of Science and Technology, Translational Medicine, Ribeirão Preto, São Paulo, Brazil
| | - Fabiana Pereira Santos
- Department of Toxicological Analyses, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, 05508-000, Brazil
| | | | - Mauricio Yonamine
- Department of Toxicological Analyses, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, 05508-000, Brazil
| | - Eliana Rodrigues
- Centre for Ethnobotanical and Ethnopharmacological Studies, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.
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White E, Kennedy T, Ruffell S, Perkins D, Sarris J. Ayahuasca and Dimethyltryptamine Adverse Events and Toxicity Analysis: A Systematic Thematic Review. Int J Toxicol 2024; 43:327-339. [PMID: 38363085 PMCID: PMC11088222 DOI: 10.1177/10915818241230916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
The objective of this paper is to conduct a systematic thematic review of adverse events, safety, and toxicity of traditional ayahuasca plant preparations and its main psychoactive alkaloids (dimethyltryptamine [DMT], harmine, harmaline, and tetrahydroharmine), including discussing clinical considerations (within clinical trials or approved settings). A systematic literature search of preclinical, clinical, epidemiological, and pharmacovigilance data (as well as pertinent reviews and case studies) was conducted for articles using the electronic databases of PubMed and Web of Science (to 6 July 2023) and PsycINFO, ClinicalTrials.gov, and Embase (to 21 September 2022) and included articles in English in peer-reviewed journals. Additionally, reference lists were searched. Due to the breadth of the area covered, we presented the relevant data in a thematic format. Our searches revealed 78 relevant articles. Data showed that ayahuasca or DMT is generally safe; however, some adverse human events have been reported. Animal models using higher doses of ayahuasca have shown abortifacient and teratogenic effects. Isolated harmala alkaloid studies have also revealed evidence of potential toxicity at higher doses, which may increase with co-administration with certain medications. Harmaline revealed the most issues in preclinical models. Nevertheless, animal models involving higher-dose synthetic isolates may not necessarily be able to be extrapolated to human use of therapeutic doses of plant-based extracts. Serious adverse effects are rarely reported within healthy populations, indicating an acceptable safety profile for the traditional use of ayahuasca and DMT in controlled settings. Further randomized, controlled trials with judicious blinding, larger samples, and longer duration are needed.
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Affiliation(s)
- Eleanor White
- Biomedicine Discovery Institute, Department of Physiology, Monash University, Melbourne, VIC, Australia
| | - Tom Kennedy
- The University of Queensland, Brisbane, QLD, Australia
| | - Simon Ruffell
- Psychae Institue, Melbourne, VIC, Australia
- Onaya Science, Iquitos, Peru
| | - Daniel Perkins
- Psychae Institue, Melbourne, VIC, Australia
- School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
- School of Social and Political Science, University of Melbourne, Melbourne, VIC, Australia
- Centre for Mental Health, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Jerome Sarris
- Psychae Institue, Melbourne, VIC, Australia
- Centre for Mental Health, Swinburne University of Technology, Melbourne, VIC, Australia
- NICM Health Research Institute, Western Sydney University, Westmead, NSW, Australia
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC, Australia
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Lauria PSS, Gomes JDM, Abreu LS, Santana RC, Nunes VLC, Couto RD, Colavolpe PO, Silva MSD, Soares MBP, Villarreal CF. Ayahuasca and its major component harmine promote antinociceptive effects in mouse models of acute and chronic pain. JOURNAL OF ETHNOPHARMACOLOGY 2024; 323:117710. [PMID: 38184028 DOI: 10.1016/j.jep.2024.117710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 12/20/2023] [Accepted: 01/02/2024] [Indexed: 01/08/2024]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Ayahuasca (AYA) is a psychedelic brew used in religious ceremonies. It is broadly used as a sacred medicine for treating several ailments, including pain of various origins. AIM OF THE STUDY To investigate the antinociceptive effects of AYA and its mechanisms in preclinical models of acute and chronic pain in mice, in particular during experimental neuropathy. MATERIALS AND METHODS The antinociceptive effects of AYA administered orally were assessed in the following models of pain: formalin test, Complete Freund's Adjuvant (CFA)-induced inflammation, tail flick test, and partial sciatic nerve ligation model of neuropathic pain. Antagonism assays and Fos immunohistochemistry in the brain were performed. AYA-induced toxicity was investigated. AYA was chemically characterized. The antinociceptive effect of harmine, the major component present in AYA, was investigated. RESULTS AYA (24-3000 μL/kg) dose-dependently reduced formalin-induced pain-like behaviors and CFA-induced mechanical allodynia but did not affect CFA-induced paw edema or tail flick latency. During experimental neuropathy, single treatments with AYA (24-3000 μL/kg) reduced mechanical allodynia; daily treatments once or twice a day for 14 days promoted consistent and sustained antinociception. The antinociceptive effect of AYA (600 μL/kg) was reverted by bicuculline (1 mg/kg) and methysergide (5 mg/kg), but not by naloxone (5 mg/kg), phaclofen (2 mg/kg), and rimonabant (10 mg/kg), suggesting the roles of GABAA and serotonergic receptors. AYA increased Fos expression in the ventrolateral periaqueductal gray and nucleus raphe magnus after 1 h, but not after 6 h or 14 days of daily treatments. AYA (600 μL/kg) twice a day for 14 days did not alter mice's motor function, spontaneous locomotion, body weight, food and water intake, hematological, biochemical, and histopathological parameters. Harmine (3.5 mg/kg) promoted consistent antinociception during experimental neuropathy. CONCLUSIONS AYA promotes consistent antinociceptive effects in different mouse models of pain without inducing detectable toxic effects. Harmine is at least partially accountable for the antinociceptive properties of AYA.
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Affiliation(s)
| | - Juliana de Medeiros Gomes
- Department of Pharmaceutical Sciences, Federal University of Paraíba, 58.050-585, João Pessoa, PB, Brazil.
| | - Lucas Silva Abreu
- Chemistry Institute, Fluminense Federal University, 24.020-150, Niterói, RJ, Brazil.
| | | | | | - Ricardo David Couto
- School of Pharmacy, Federal University of Bahia, 40.170-115, Salvador, BA, Brazil; School of Medicine, University Center of Technology and Science, 41.800-700, Salvador, BA, Brazil.
| | | | - Marcelo Sobral da Silva
- Department of Pharmaceutical Sciences, Federal University of Paraíba, 58.050-585, João Pessoa, PB, Brazil.
| | - Milena Botelho Pereira Soares
- Gonçalo Moniz Institute, FIOCRUZ, 40.296-710, Salvador, BA, Brazil; Institute of Advanced Systems in Health, SENAI CIMATEC, 41.650-010, Salvador, BA, Brazil.
| | - Cristiane Flora Villarreal
- School of Pharmacy, Federal University of Bahia, 40.170-115, Salvador, BA, Brazil; Gonçalo Moniz Institute, FIOCRUZ, 40.296-710, Salvador, BA, Brazil.
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Williams M, Kingston Miller A, Lafrance A. Ayahuasca ceremony leaders' perspectives on special considerations for eating disorders. Eat Disord 2024; 32:120-139. [PMID: 37943076 DOI: 10.1080/10640266.2023.2271201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
Eating disorders (EDs) are difficult conditions to resolve, necessitating novel treatments. Ayahuasca, a psychedelic plant medicine originating in Indigenous Amazonian communities, is being investigated. Aspects of ceremonial ayahuasca use (purging, dietary restrictions) appear similar to ED behaviors, raising questions about ayahuasca's suitability as an intervention for individuals with EDs. This study explored the perspectives of ayahuasca ceremony leaders on these and other considerations for ceremonial ayahuasca drinking among individuals with EDs. A qualitative content analysis of interviews was undertaken with 15 ayahuasca ceremony leaders, the majority of whom were from the West/Global North. Screening for EDs, purging and dietary restrictions, potential risks and dangers, and complementarity with conventional ED treatment emerged as categories. The findings offer ideas, including careful screening and extra support, to promote safe and beneficial ceremony experiences for ceremony participants with EDs. More research is needed to clarify the impacts of ceremony-related purging and preparatory diets. To evolve conventional models of treatment, the ED field could consider Indigenous approaches to mental health whereby ayahuasca ceremony leaders and ED researchers and clinicians collaborate in a decolonizing, bidirectional bridging process between Western and Indigenous paradigms of healing.
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Affiliation(s)
- Meris Williams
- Independent Researcher, Vancouver, British Columbia, Canada
| | - Annie Kingston Miller
- School of Rural and Northern Health, Laurentian University, Sudbury, Ontario, Canada
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Solaja I, Haldane K, Mason N, Weiss B, Xu X, Xu M, Nikolin S, Jayasena T, Millard M, Brett J, Bayes A, Loo CK, Martin DM. Who are you after psychedelics? A systematic review and a meta-analysis of the magnitude of long-term effects of serotonergic psychedelics on cognition/creativity, emotional processing and personality. Neurosci Biobehav Rev 2024; 158:105570. [PMID: 38311046 DOI: 10.1016/j.neubiorev.2024.105570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 01/29/2024] [Accepted: 01/31/2024] [Indexed: 02/06/2024]
Abstract
This systematic review and a meta-analysis synthesised the results from contemporary, randomized and non-randomized controlled studies to assess lasting (one week minimum) changes on cognition/creativity, emotional processing and personality from serotonergic psychedelics. PubMed, Embase and PsycInfo were searched in July 2022. Risk of bias was assessed using Rob 2.0 and ROBINS-I. Ten studies met the eligibility criteria which involved 304 participants. No statistically significant effects were found for the majority outcome measures across the three constructs. A meta-analysis of emotional recognition outcomes found an overall significant effect for faster reaction times in the active treatment groups for disgust (SMD=-0.63, 95% CI=[-1.01 to -0.25], I2 = 65%) and sadness (SMD=-0.45, 95% CI=[-0.85 to -0.06], I2 = 60%). Future research should include larger samples, better control conditions, standardized doses and longer follow-up periods to confirm these preliminary findings.
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Affiliation(s)
- Ivana Solaja
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, Australia.
| | | | - Natasha Mason
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Brandon Weiss
- Centre for Psychedelic Research, Division of Academic Psychiatry, Imperial College London, London, UK
| | - Xiaomin Xu
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Mei Xu
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Stevan Nikolin
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, Australia; Black Dog Institute, Sydney, Australia
| | - Tharusha Jayasena
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | | | | | - Adam Bayes
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, Australia; Black Dog Institute, Sydney, Australia
| | - Colleen K Loo
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, Australia; Black Dog Institute, Sydney, Australia
| | - Donel M Martin
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, Australia; Black Dog Institute, Sydney, Australia
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Aicher HD, Mueller MJ, Dornbierer DA, Suay D, Elsner C, Wicki I, Meling D, Caflisch L, Hempe A, Steinhart C, Mueller J, Von Rotz R, Kleim B, Scheidegger M. Potential therapeutic effects of an ayahuasca-inspired N,N-DMT and harmine formulation: a controlled trial in healthy subjects. Front Psychiatry 2024; 14:1302559. [PMID: 38264636 PMCID: PMC10804806 DOI: 10.3389/fpsyt.2023.1302559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 12/15/2023] [Indexed: 01/25/2024] Open
Abstract
Background There is growing scientific evidence for the therapeutic benefits of the Amazonian plant-based psychedelic "ayahuasca" for neuropsychiatric disorders such as depression and anxiety. However, there are certain challenges when incorporating botanical ayahuasca into biomedical research and clinical therapy environments. Formulations inspired by ayahuasca, which contain specific and standardized active components, are a potential remedy. Methods We investigated subjective acute and persisting effects of a novel formulation containing the reversible monoamine oxidase inhibitor harmine (orodispersible tablet containing 100 mg MAO-I) and N,N-dimethyltryptamine (incremental intranasal dosing of up to 100 mg DMT), compared with two other conditions, namely harmine alone and placebo, in a crossover RCT in 31 healthy male subjects. Results DMT + harmine, but not harmine alone, induced a psychedelic experience assessed with the 5D-ASC rating scale [global score: F(2,60) = 80.21, p < 0.001] and acute experience sampling items over time, characterized by psychological insights [PIQ, F(2,58.5) = 28.514, p < 0.001], emotional breakthroughs [EBI, F(2,60) = 26.509, p < 0.001], and low scores on the challenging experience questionnaire [CEQ, F(2,60) = 12.84, p < 0.001]. Participants attributed personal and spiritual significance to the experience (GSR) with mainly positive persisting effects (PEQ) at 1- and 4-months follow-up. Acute drug effects correlated positively with persisting effects. We found no changes in trait measures of personality, psychological flexibility, or general well-being, and no increases in psychopathology (SCL-90-R) were reported. Discussion and Conclusion Our results suggest that the experience induced by the standardized DMT + harmine formulation induces a phenomenologically rich psychedelic experience, demonstrates good psychological safety and tolerability, is well tolerated, and induces beneficial psychological processes that could possibly support psychotherapy. Further studies are required to investigate the psychotherapeutic potential in patients.
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Affiliation(s)
- Helena D. Aicher
- Psychedelic Research and Therapy Development, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Department of Psychology, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich and ETH, Zurich, Switzerland
| | - Michael J. Mueller
- Psychedelic Research and Therapy Development, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich and ETH, Zurich, Switzerland
- Department of Health Science and Technology, ETH, Zurich, Switzerland
| | - Dario A. Dornbierer
- Psychedelic Research and Therapy Development, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Institute of Pharmacology and Toxicology, University of Zurich, Zurich, Switzerland
- Department of Forensic Pharmacology and Toxicology, University of Zurich, Zurich, Switzerland
| | - Dila Suay
- Psychedelic Research and Therapy Development, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
- MoMiLab, IMT School for Advanced Studies Luca, Lucca, Italy
| | - Claudius Elsner
- Psychedelic Research and Therapy Development, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Ilhui Wicki
- Psychedelic Research and Therapy Development, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Daniel Meling
- Psychedelic Research and Therapy Development, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Department of Psychosomatic Medicine and Psychotherapy, Medical Center–University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Luzia Caflisch
- Psychedelic Research and Therapy Development, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Alexandra Hempe
- Psychedelic Research and Therapy Development, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Biopsychology, Department of Psychology, TUD Dresden University of Technology, Dresden, Germany
| | - Camilla Steinhart
- Psychedelic Research and Therapy Development, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Jovin Mueller
- Psychedelic Research and Therapy Development, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Robin Von Rotz
- Psychedelic Research and Therapy Development, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Birgit Kleim
- Department of Psychology, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich and ETH, Zurich, Switzerland
- Experimental Psychopathology and Psychotherapy, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Milan Scheidegger
- Psychedelic Research and Therapy Development, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich and ETH, Zurich, Switzerland
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David J, Bouso JC, Kohek M, Ona G, Tadmor N, Arnon T, Dor-Ziderman Y, Berkovich-Ohana A. Ayahuasca-induced personal death experiences: prevalence, characteristics, and impact on attitudes toward death, life, and the environment. Front Psychiatry 2023; 14:1287961. [PMID: 38169823 PMCID: PMC10758466 DOI: 10.3389/fpsyt.2023.1287961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 11/22/2023] [Indexed: 01/05/2024] Open
Abstract
Introduction Despite an emerging understanding regarding the pivotal mechanistic role of subjective experiences that unfold during acute psychedelic states, very little has been done in the direction of better characterizing such experiences and determining their long-term impact. The present paper utilizes two cross-sectional studies for spotlighting - for the first time in the literature - the characteristics and outcomes of self-reported past experiences related to one's subjective sense of death during ayahuasca ceremonies, termed here Ayahuasca-induced Personal Death (APD) experiences. Methods Study 1 (n = 54) reports the prevalence, demographics, intensity, and impact of APDs on attitudes toward death, explores whether APDs are related with psychopathology, and reveals their impact on environmental concerns. Study 2 is a larger study (n = 306) aiming at generalizing the basic study 1 results regarding APD experience, and in addition, examining whether APDs is associated with self-reported coping strategies and values in life. Results Our results indicate that APDs occur to more than half of those participating in ayahuasca ceremonies, typically manifest as strong and transformative experiences, and are associated with an increased sense of transcending death (study 1), as well as the certainty in the continuation of consciousness after death (study 2). No associations were found between having undergone APD experiences and participants' demographics, personality type, and psychopathology. However, APDs were associated with increased self-reported environmental concern (study 1). These experiences also impact life in profound ways. APDs were found to be associated with increases in one's self-reported ability to cope with distress-causing life problems and the sense of fulfillment in life (study 2). Discussion The study's findings highlight the prevalence, safety and potency of death experiences that occur during ayahuasca ceremonies, marking them as possible mechanisms for psychedelics' long-term salutatory effects in non-clinical populations. Thus, the present results join other efforts of tracking and characterizing the profound subjective experiences that occur during acute psychedelic states.
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Affiliation(s)
- Jonathan David
- Edmond J. Safra Brain Research Center, University of Haifa, Haifa, Israel
- Integrated Brain and Behavior Research Center (IBBRC), University of Haifa, Haifa, Israel
- Department of Counseling and Human Development, Faculty of Education, University of Haifa, Haifa, Israel
| | - José Carlos Bouso
- International Center for Ethnobotanical Education, Research & Service (ICEERS), Barcelona, Spain
- Medical Anthropology Research Center (MARC), Department of Anthropology, Philosophy and Social Work, Universitat Rovira i Virgili, Tarragona, Spain
- Department of Neurosciences and Behavior, University of São Paulo, São Paulo, Brazil
| | - Maja Kohek
- International Center for Ethnobotanical Education, Research & Service (ICEERS), Barcelona, Spain
- Medical Anthropology Research Center (MARC), Department of Anthropology, Philosophy and Social Work, Universitat Rovira i Virgili, Tarragona, Spain
| | - Genís Ona
- International Center for Ethnobotanical Education, Research & Service (ICEERS), Barcelona, Spain
- Medical Anthropology Research Center (MARC), Department of Anthropology, Philosophy and Social Work, Universitat Rovira i Virgili, Tarragona, Spain
| | - Nir Tadmor
- Department of Counseling and Human Development, Faculty of Education, University of Haifa, Haifa, Israel
| | - Tal Arnon
- Integral Transpersonal Psychology, California Institute of Integral Studies, San Francisco, CA, United States
| | - Yair Dor-Ziderman
- Edmond J. Safra Brain Research Center, University of Haifa, Haifa, Israel
- Integrated Brain and Behavior Research Center (IBBRC), University of Haifa, Haifa, Israel
- Department of Counseling and Human Development, Faculty of Education, University of Haifa, Haifa, Israel
| | - Aviva Berkovich-Ohana
- Edmond J. Safra Brain Research Center, University of Haifa, Haifa, Israel
- Integrated Brain and Behavior Research Center (IBBRC), University of Haifa, Haifa, Israel
- Department of Counseling and Human Development, Faculty of Education, University of Haifa, Haifa, Israel
- Department of Learning and Instructional Sciences, Faculty of Education, University of Haifa, Haifa, Israel
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8
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Ruffell SGD, Crosland‐Wood M, Palmer R, Netzband N, Tsang W, Weiss B, Gandy S, Cowley‐Court T, Halman A, McHerron D, Jong A, Kennedy T, White E, Perkins D, Terhune DB, Sarris J. Ayahuasca: A review of historical, pharmacological, and therapeutic aspects. PCN REPORTS : PSYCHIATRY AND CLINICAL NEUROSCIENCES 2023; 2:e146. [PMID: 38868739 PMCID: PMC11114307 DOI: 10.1002/pcn5.146] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 08/13/2023] [Accepted: 08/30/2023] [Indexed: 06/14/2024]
Abstract
Ayahuasca is a psychedelic plant brew originating from the Amazon rainforest. It is formed from two basic components, the Banisteriopsis caapi vine and a plant containing the potent psychedelic dimethyltryptamine (DMT), usually Psychotria viridis. Here we review the history of ayahuasca and describe recent work on its pharmacology, phenomenological responses, and clinical applications. There has been a significant increase in interest in ayahuasca since the turn of the millennium. Anecdotal evidence varies significantly, ranging from evangelical accounts to horror stories involving physical and psychological harm. The effects of the brew on personality and mental health outcomes are discussed in this review. Furthermore, phenomenological analyses of the ayahuasca experience are explored. Ayahuasca is a promising psychedelic agent that warrants greater empirical attention regarding its basic neurochemical mechanisms of action and potential therapeutic application.
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Affiliation(s)
- Simon G. D. Ruffell
- Onaya ScienceIquitosPeru
- Psychae InstituteMelbourneVictoriaAustralia
- School of Population and Global HealthUniversity of MelbourneMelbourneAustralia
| | - Max Crosland‐Wood
- Onaya ScienceIquitosPeru
- Psychology and Psychotherapy departmentCentral and North West London NHS TrustLondonUK
| | - Rob Palmer
- Onaya ScienceIquitosPeru
- School of MedicineUniversity of YaleNew HavenConnecticutUSA
- Department of PsychologyUniversity of New MexicoAlbuquerqueNew MexicoUSA
| | | | - WaiFung Tsang
- Onaya ScienceIquitosPeru
- Institute of Psychology, Psychiatry and NeuroscienceSouth London and The Maudsley NHS TrustLondonUK
- Department of Psychology, Institute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK
| | - Brandon Weiss
- Onaya ScienceIquitosPeru
- Division of PsychiatryImperial College LondonLondonUK
| | | | - Tessa Cowley‐Court
- Psychae InstituteMelbourneVictoriaAustralia
- School of Population and Global HealthUniversity of MelbourneMelbourneAustralia
| | - Andreas Halman
- School of Population and Global HealthUniversity of MelbourneMelbourneAustralia
| | | | - Angelina Jong
- Institute of Psychology, Psychiatry and NeuroscienceSouth London and The Maudsley NHS TrustLondonUK
- Department of Psychology, Institute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK
| | | | | | - Daniel Perkins
- Psychae InstituteMelbourneVictoriaAustralia
- School of Population and Global HealthUniversity of MelbourneMelbourneAustralia
- Centre for Mental HealthSwinburne UniversityMelbourneAustralia
| | - Devin B. Terhune
- Psychology and Psychotherapy departmentCentral and North West London NHS TrustLondonUK
| | - Jerome Sarris
- Psychae InstituteMelbourneVictoriaAustralia
- NICM Health Research InstituteWestern Sydney UniversitySydneyAustralia
- Florey Institute for Neuroscience and Mental HealthUniversity of MelbourneMelbourneAustralia
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Ramaekers JG, Mallaroni P, Kloft L, Reckweg JT, Toennes SW, van Oorsouw K, Mason NL. Altered State of Consciousness and Mental Imagery as a Function of N, N-dimethyltryptamine Concentration in Ritualistic Ayahuasca Users. J Cogn Neurosci 2023; 35:1382-1393. [PMID: 37159257 DOI: 10.1162/jocn_a_02003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Consumption of the psychedelic brew ayahuasca is a central ritualistic aspect of the Santo Daime religion. The current observational, baseline controlled study was designed to assess whether members (n = 24) of the Santo Daime church would show enhanced capacity for mental imagery during an ayahuasca experience. In addition, this study assessed whether the effects of ayahuasca on consciousness and mental imagery were related to peak serum concentration of N, N-dimethyltryptamine (DMT), the main psychoactive component. Measures of altered states of consciousness (5-Dimensional Altered States of Consciousness Questionnaire) and ego dissolution (Ego Dissolution Inventory [EDI]) as well as measures of mental imagery (visual perspective shifting, vividness of visual imagery, cognitive flexibility, associative thinking) were taken on two subsequent days on which members of Santo Daime were sober or drank a self-selected volume of ayahuasca. Measures of altered states of consciousness revealed that feelings of oceanic boundlessness, visual restructuralization, and EDI increased most prominently after drinking and shared a positive correlation with peak DMT concentration. Measures of mental imagery did not noticeably differ between the baseline and ayahuasca condition, although subjective ratings of cognitive flexibility were lower under ayahuasca. Two measures related to mental imagery, that is, perspective shifts and cognitive flexibility, were significantly correlated to peak DMT concentrations. Peak concentrations of DMT and other alkaloids did not correlate with ayahuasca dose. These findings confirm previous notions that the primary phenomenological characteristics of ayahuasca are driven by DMT. Compensatory or neuroadaptive effects associated with long-term ayahuasca intake may have mitigated the acute impact of ayahuasca in Santo Daime members on mental imagery.
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10
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Gonçalves J, Luís Â, Gallardo E, Duarte AP. A Systematic Review on the Therapeutic Effects of Ayahuasca. PLANTS (BASEL, SWITZERLAND) 2023; 12:2573. [PMID: 37447135 DOI: 10.3390/plants12132573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 07/04/2023] [Accepted: 07/05/2023] [Indexed: 07/15/2023]
Abstract
Traditional therapies, resorting to the use of plants, have acquired a great demand over the years, both for economic reasons and the preference for natural treatments. Some studies suggest that ayahuasca may have beneficial properties in treating some physical and psychological imbalances. Thus, we carried out a systematic review of studies published up to December 2022, where these themes were addressed. The search was carried out in the PubMed database, and only studies written in English and published in peer-reviewed journals were included. Thus, 228 publications were identified, of which 66 were included in the present study. The reviewed studies suggest that ayahuasca may have beneficial effects on various physical and psychological conditions, namely in the treatment of depression, anxiety and various diseases of the neurobiological system, as well as anti-inflammatory and antimicrobial properties, demonstrating its therapeutic potential. The number of studies that address this issue has also been growing, demonstrating interest in the search for alternative treatments. However, to the best of our knowledge, this is the first systematic review where all the findings of therapeutic effects associated with the consumption of ayahuasca are reviewed.
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Affiliation(s)
- Joana Gonçalves
- Centro de Investigação em Ciências da Saúde (CICS-UBI), Universidade da Beira Interior, Av. Infante D. Henrique, 6200-506 Covilhã, Portugal
- Laboratório de Fármaco-Toxicologia, UBIMedical, Universidade da Beira Interior, Estrada Municipal 506, 6200-284 Covilhã, Portugal
| | - Ângelo Luís
- Centro de Investigação em Ciências da Saúde (CICS-UBI), Universidade da Beira Interior, Av. Infante D. Henrique, 6200-506 Covilhã, Portugal
- Laboratório de Fármaco-Toxicologia, UBIMedical, Universidade da Beira Interior, Estrada Municipal 506, 6200-284 Covilhã, Portugal
| | - Eugenia Gallardo
- Centro de Investigação em Ciências da Saúde (CICS-UBI), Universidade da Beira Interior, Av. Infante D. Henrique, 6200-506 Covilhã, Portugal
- Laboratório de Fármaco-Toxicologia, UBIMedical, Universidade da Beira Interior, Estrada Municipal 506, 6200-284 Covilhã, Portugal
| | - Ana Paula Duarte
- Centro de Investigação em Ciências da Saúde (CICS-UBI), Universidade da Beira Interior, Av. Infante D. Henrique, 6200-506 Covilhã, Portugal
- Laboratório de Fármaco-Toxicologia, UBIMedical, Universidade da Beira Interior, Estrada Municipal 506, 6200-284 Covilhã, Portugal
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11
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Barnby JM, Park S, Baxter T, Rosen C, Brugger P, Alderson-Day B. The felt-presence experience: from cognition to the clinic. Lancet Psychiatry 2023; 10:352-362. [PMID: 36990104 DOI: 10.1016/s2215-0366(23)00034-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 01/14/2023] [Accepted: 01/19/2023] [Indexed: 03/31/2023]
Abstract
The felt presence experience is the basic feeling that someone else is present in the immediate environment, without clear sensory evidence. Ranging from benevolent to distressing, personified to ambiguous, felt presence has been observed in neurological case studies and within psychosis and paranoia, associated with sleep paralysis and anxiety, and recorded within endurance sports and spiritualist communities. In this Review, we summarise the philosophical, phenomenological, clinical, and non-clinical correlates of felt presence, as well as current approaches that use psychometric, cognitive, and neurophysiological methods. We present current mechanistic explanations for felt presence, suggest a unifying cognitive framework for the phenomenon, and discuss outstanding questions for the field. Felt presence offers a sublime opportunity to understand the cognitive neuroscience of own-body awareness and social agency detection, as an intuitive, but poorly understood, experience in health and disorder.
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Affiliation(s)
- Joseph M Barnby
- Social Computation and Cognitive Representation Lab, Department of Psychology, Royal Holloway, University of London, London, UK.
| | - Sohee Park
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | - Tatiana Baxter
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | - Cherise Rosen
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| | - Peter Brugger
- Neuropsychology Unit, Valens Rehabilitation Centre, Zurich, Switzerland; University Hospital of Psychiatry, Zurich, Switzerland
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12
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Daldegan-Bueno D, Simionato NM, Favaro VM, Maia LO. The current state of ayahuasca research in animal models: A systematic review. Prog Neuropsychopharmacol Biol Psychiatry 2023; 125:110738. [PMID: 36863501 DOI: 10.1016/j.pnpbp.2023.110738] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 02/22/2023] [Accepted: 02/25/2023] [Indexed: 03/04/2023]
Abstract
RATIONALE The psychedelic brew ayahuasca is increasingly being investigated for its therapeutic potential. Animal models are essential to investigate the pharmacological effects of ayahuasca since they can control important factors influencing it, such as the set and setting. OBJECTIVE Review and summarise data available on ayahuasca research using animal models. METHODS We systematically searched five databases (PubMed, Web of Science, EMBASE, LILACS and PsycInfo) for peer-reviewed studies in English, Portuguese or Spanish published up to July 2022. The search strategy included ayahuasca- and animal model-related terms adapted from the SYRCLE search syntax. RESULTS We identified 32 studies investigating ayahuasca effects on toxicological, behavioural and (neuro)biological parameters in rodents, primates and zebrafish. Toxicological results show that ayahuasca is safe at ceremonial-based doses but toxic at high doses. Behavioural results indicate an antidepressant effect and a potential to reduce the reward effects of ethanol and amphetamines, while the anxiety-related outcomes are yet inconclusive; also, ayahuasca can influence locomotor activity, highlighting the importance of controlling the analysis for locomotion when using tasks depending on it. Neurobiological results show that ayahuasca affects brain structures involved in memory, emotion and learning and that other neuropathways, besides the serotonergic action, are important in modulating its effects. CONCLUSIONS Studies using animal models indicate that ayahuasca is toxicologically safe in ceremonial-comparable doses and indicates a therapeutic potential for depression and substance use disorder while not supporting an anxiolytic effect. Essential gaps in the ayahuasca field can still be sufficed using animal models.
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Affiliation(s)
- Dimitri Daldegan-Bueno
- Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil; Centre for Applied Research in Mental Health and Addiction, Faculty of Health Sciences, Simon Fraser University, Vancouver, British Columbia, Canada
| | | | - Vanessa Manchim Favaro
- Division of Neuromuscular Diseases, Department of Neurology and Neurosurgery, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Lucas Oliveira Maia
- Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil; Brain Institute, Federal University of Rio Grande do Norte (UFRN), Natal, Brazil; Interdisciplinary Center for Studies in Palliative Care (CIECP), School of Nursing, Federal University of Alfenas (UNIFAL-MG), Alfenas, Brazil
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13
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Apud I. Ayahuasca and personality. A systematic review and meta-analysis of cross-sectional studies with long-term participants ( Ayahuasca y personalidad. Revisión sistemática y metaanálisis de estudios transversales con participantes de larga trayectoria). STUDIES IN PSYCHOLOGY 2023. [DOI: 10.1080/02109395.2022.2163776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
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Perkins D, Ruffell SGD, Day K, Pinzon Rubiano D, Sarris J. Psychotherapeutic and neurobiological processes associated with ayahuasca: A proposed model and implications for therapeutic use. Front Neurosci 2023; 16:879221. [PMID: 36798604 PMCID: PMC9928213 DOI: 10.3389/fnins.2022.879221] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 12/12/2022] [Indexed: 02/01/2023] Open
Abstract
Ayahuasca is a psychoactive Amazonian plant brew. It is usually made from the Banisteriopsis caapi vine (Spruce ex Griseb. Morton, Malpighiaceae), which contains three primary harmala alkaloids, along with the leaves of Psychotria viridis (Ruiz et Pavon, Rubiaceae) in which the potent psychedelic dimethyltryptamine (DMT) is found. DMT-harmaloid concoctions have gained popularity in recent years, due to growing anecdotal and scientific reports of therapeutic benefits associated with their consumption. Ayahuasca is now ingested in a variety of different settings across the globe, from traditional ethnobotanical to so called "neo-shamanic" ceremonies. Furthermore, related preparations involving alternative sources of DMT and harmala alkaloids are becoming increasingly common as knowledge of ayahuasca continues to spread internationally. This article reviews the existing literature and draws on original qualitative data from a large cross-sectional study of ayahuasca drinkers, to propose a model of psychotherapeutic processes associated with the consumption of ayahuasca. We assert that it is these processes, facilitated by a range of neurobiological effects, that lead to beneficial mental health and wellbeing outcomes. Our proposed model identifies five key psychotherapeutic processes or effects inherent to the ayahuasca experience; somatic effects; introspection and emotional processing; increased Self-connection; increased spiritual connection, and finally the gaining of insights and new perspectives. We note some important differences in these processes compared with other classic psychedelics as well as the implications of the model for the therapeutic use of ayahuasca. Improved understanding of the psychotherapeutic processes involved with the ayahuasca experience will better equip practitioners to work with this potentially transformative concoction and enable the optimization of therapeutic treatment models for potential clinical use.
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Affiliation(s)
- Daniel Perkins
- School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia,School of Social and Political Science, University of Melbourne, Melbourne, VIC, Australia,Psychae Institute, Melbourne, VIC, Australia,Centre for Mental Health, Swinburne University, Melbourne, VIC, Australia,*Correspondence: Daniel Perkins,
| | - Simon G. D. Ruffell
- School of Social and Political Science, University of Melbourne, Melbourne, VIC, Australia,Psychae Institute, Melbourne, VIC, Australia,Centre for Mental Health, Swinburne University, Melbourne, VIC, Australia,Onaya Science, Iquitos, Peru
| | | | | | - Jerome Sarris
- Psychae Institute, Melbourne, VIC, Australia,NICM Health Research Institute, Western Sydney University, Sydney, NSW, Australia,Florey Institute of Neuroscience and Mental Health, Melbourne, VIC, Australia
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15
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Ayahuasca's therapeutic potential: What we know - and what not. Eur Neuropsychopharmacol 2023; 66:45-61. [PMID: 36368095 DOI: 10.1016/j.euroneuro.2022.10.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 10/08/2022] [Accepted: 10/14/2022] [Indexed: 11/10/2022]
Abstract
The therapeutic potential of the psychedelic brew ayahuasca has been investigated in preclinical and clinical studies. Currently, the most consistent evidence refers to depression. However, various studies suggest that ayahuasca may comprise therapeutic benefits in other health conditions. This narrative review provides a comprehensive, up-to-date overview of ayahuasca's therapeutic effects in diverse clinical conditions in human (clinical, cross-sectional, observational, and qualitative) and preclinical (animal and in vitro) studies. In addition to summarizing and discussing the most commonly studied conditions, such as depression, anxiety, and substance use disorders (SUD), we also examine less frequently studied psychiatric, neurological, and physical conditions. Moreover, we discuss evidence from epidemiological studies on the impact of regular, long-term ayahuasca use on health and psychosocial outcomes. Overall, evidence for depression and SUD is more consistent, with numerous and diverse studies. However, a growing body of evidence suggests that other conditions equally relevant to public health might be promising targets for ayahuasca's therapeutic effects. This includes preliminary studies indicating potential for grief, eating disorders, posttraumatic stress disorder, personality disorders, Parkinson's and Alzheimer's disease, and severe physical illnesses (e.g., cancer, chronic conditions). Moreover, preliminary evidence in long-term ayahuasca users does not suggest detrimental effects but possible benefits for individual and collective health. In light of the emerging evidence of psychedelic drugs as therapeutic agents, it is essential to further investigate in rigorous designs the therapeutic potential of ayahuasca in conditions other than depression.
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Breeksema JJ, Kuin BW, Kamphuis J, van den Brink W, Vermetten E, Schoevers RA. Adverse events in clinical treatments with serotonergic psychedelics and MDMA: A mixed-methods systematic review. J Psychopharmacol 2022; 36:1100-1117. [PMID: 36017784 PMCID: PMC9548934 DOI: 10.1177/02698811221116926] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Small-scale clinical studies with psychedelic drugs have shown promising results for the treatment of several mental disorders. Before psychedelics become registered medicines, it is important to know the full range of adverse events (AEs) for making balanced treatment decisions. OBJECTIVE To systematically review the presence of AEs during and after administration of serotonergic psychedelics and 3,4-methyenedioxymethamphetamine (MDMA) in clinical studies. METHODS We systematically searched PubMed, PsycINFO, Embase, and ClinicalTrials.gov for clinical trials with psychedelics since 2000 describing the results of quantitative and qualitative studies. RESULTS We included 44 articles (34 quantitative + 10 qualitative), describing treatments with MDMA and serotonergic psychedelics (psilocybin, lysergic acid diethylamide, and ayahuasca) in 598 unique patients. In many studies, AEs were not systematically assessed. Despite this limitation, treatments seemed to be overall well tolerated. Nausea, headaches, and anxiety were commonly reported acute AEs across diagnoses and compounds. Late AEs included headaches (psilocybin, MDMA), fatigue, low mood, and anxiety (MDMA). One serious AE occurred during MDMA administration (increase in premature ventricular contractions requiring brief hospitalization); no other AEs required medical intervention. Qualitative studies suggested that psychologically challenging experiences may also be therapeutically beneficial. Except for ayahuasca, a large proportion of patients had prior experience with psychedelic drugs before entering studies. CONCLUSIONS AEs are poorly defined in the context of psychedelic treatments and are probably underreported in the literature due to study design (lack of systematic assessment of AEs) and sample selection. Acute challenging experiences may be therapeutically meaningful, but a better understanding of AEs in the context of psychedelic treatments requires systematic and detailed reporting.
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Affiliation(s)
- Joost J Breeksema
- Department of Psychiatry, University of
Groningen, University Medical Center Groningen, Groningen, The Netherlands,Department of Psychiatry, Leiden
University Medical Center, Leiden, The Netherlands,OPEN Foundation, Amsterdam, The
Netherlands,Joost J Breeksema, University Center of
Psychiatry, University Medical Center Groningen, Hanzeplein 1, Groningen 9700
RB, The Netherlands.
| | - Bouwe W Kuin
- Department of Psychiatry, University of
Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Jeanine Kamphuis
- Department of Psychiatry, University of
Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Wim van den Brink
- Department of Psychiatry, Amsterdam
University Medical Center, Amsterdam, The Netherlands
| | - Eric Vermetten
- Department of Psychiatry, Leiden
University Medical Center, Leiden, The Netherlands
| | - Robert A Schoevers
- Department of Psychiatry, University of
Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Schenberg EE, Gerber K. Overcoming epistemic injustices in the biomedical study of ayahuasca: Towards ethical and sustainable regulation. Transcult Psychiatry 2022; 59:610-624. [PMID: 34986699 DOI: 10.1177/13634615211062962] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
After decades of biomedical research on ayahuasca's molecular compounds and their physiological effects, recent clinical trials show evidence of therapeutic potential for depression. However, indigenous peoples have been using ayahuasca therapeutically for a very long time, and thus we question the epistemic authority attributed to scientific studies, proposing that epistemic injustices were committed with practical, cultural, social, and legal consequences. We question epistemic authority based on the double-blind design, the molecularization discourse, and contextual issues about safety. We propose a new approach to foster epistemically fair research, outlining how to enforce indigenous rights, considering the Brazilian, Peruvian, and Colombian cases. Indigenous peoples have the right to maintain, control, protect, and develop their biocultural heritage, traditional knowledge, and cultural expressions, including traditional medicine practices. New regulations about ayahuasca must respect the free, prior, and informed consent of indigenous peoples according to the International Labor Organization Indigenous and Tribal Peoples Convention no. 169. The declaration of the ayahuasca complex as a national cultural heritage may prevent patenting from third parties, fostering the development of traditional medicine. When involving isolated compounds derived from traditional knowledge, benefit-sharing agreements are mandatory according to the United Nations' Convention on Biological Diversity. Considering the extremely high demand to treat millions of depressed patients, the medicalization of ayahuasca without adequate regulation respectful of indigenous rights can be detrimental to indigenous peoples and their management of local environments, potentially harming the sustainability of the plants and of the Amazon itself, which is approaching its dieback tipping point.
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Goulart da Silva M, Daros GC, Santos FP, Yonamine M, de Bitencourt RM. Antidepressant and anxiolytic-like effects of ayahuasca in rats subjected to LPS-induced neuroinflammation. Behav Brain Res 2022; 434:114007. [PMID: 35843462 DOI: 10.1016/j.bbr.2022.114007] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 06/30/2022] [Accepted: 07/13/2022] [Indexed: 11/28/2022]
Abstract
The objective of this study was to evaluate the behavioral response of ayahuasca in rats submitted to neuroinflammation through the intraperitoneal application of lipopolysaccharide (0.63 mg/kg/mL). Eighty animals, male, about 90 days old, were divided into control and LPS groups and later into prevention and treatment subgroups. The prevention subgroup was administered ayahuasca or saline solution, via gavage, at a dose of 4 mL/kg one hour before applying LPS or saline, while the treatment subgroup received the same dose of the respective substances 24 h after intraperitoneal applications. Behavioral parameters were evaluated using open field (anxiety-like) and forced swimming (depressive-like) tests. A decrease in LPS/AYA rats in the prevention and treatment subgroups regarding anxiety-like behavior was observed. As for the depressive-like behavior, there was a decrease in the group induced to the disease model, both in the prevention subgroup (when compared to the SAL/SAL, SAL/AYA, and LPS/AYA with LPS/SAL groups) and in the treatment (when comparing SAL/SAL and LPS/AYA with LPS/SAL). This study concludes the anxiolytic and antidepressant potential of ayahuasca in an animal model of neuroinflammation, possibly due to the antineuroinflammatory effects already reported of the compound.
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Affiliation(s)
- Marina Goulart da Silva
- Behavioral Neuroscience Laboratory. University of Southern Santa Catarina, Santa Catarina, Brazil.
| | - Guilherme Cabreira Daros
- Behavioral Neuroscience Laboratory. University of Southern Santa Catarina, Santa Catarina, Brazil.
| | - Fabiana Pereira Santos
- Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
| | - Mauricio Yonamine
- Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
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Rodrigues LS, Rossi GN, Rocha JM, L Osório F, Bouso JC, Hallak JEC, Dos Santos RG. Effects of ayahuasca and its alkaloids on substance use disorders: an updated (2016-2020) systematic review of preclinical and human studies. Eur Arch Psychiatry Clin Neurosci 2022; 272:541-556. [PMID: 33914164 DOI: 10.1007/s00406-021-01267-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 04/22/2021] [Indexed: 12/09/2022]
Abstract
Ayahuasca is a hallucinogenic/psychedelic traditionally used for ritual and therapeutic purposes. One such therapeutic use is related to Substance Use Disorders (SUDs). A previous systematic review of preclinical and human studies published until 2016 suggested that ayahuasca and its alkaloids have therapeutic effects in the treatment of SUDs. To conduct an update of this previous review. A systematic review of quantitative studies which analyzed the effects of ayahuasca and its alkaloids on drug use (primary outcome) and other measures (secondary outcomes) related to SUDs was conducted, including articles from 2016 to 2020. Nine studies (four preclinical, five observational) were included in the review. Preclinical studies in rodents reported reductions in amphetamine self-administration and anxiety, and in alcohol- and methylphenidate-induced conditioned place preference. Observational studies among healthy ritual ayahuasca users and patients with SUDs reported reductions in drug use, anxiety, and depression, and increases in quality of life and well-being. We replicated the findings of the previous review suggesting that ayahuasca and its alkaloids have therapeutic effects in the treatment of SUDs. However, translation of preclinical data to humans is limited, observational studies do not allow us to infer causality, and there is a lack of standardization on ayahuasca doses. Although promising, randomized, controlled trials are needed to better elucidate these results. The PROSPERO ID for this study is CRD42020192046.
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Affiliation(s)
- Lucas Silva Rodrigues
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Giordano Novak Rossi
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Juliana Mendes Rocha
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Flávia L Osório
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
- National Institute of Science and Technology, Translational Medicine, Ribeirão Preto, Brazil
| | - José Carlos Bouso
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
- ICEERS Foundation, International Center for Ethnobotanical Education, Research and Services, Barcelona, Spain
- Medical Anthopology Research Center, Universitat Rovira i Virgili, Tarragona, Spain
| | - Jaime E Cecílio Hallak
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
- National Institute of Science and Technology, Translational Medicine, Ribeirão Preto, Brazil
| | - Rafael G Dos Santos
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.
- National Institute of Science and Technology, Translational Medicine, Ribeirão Preto, Brazil.
- ICEERS Foundation, International Center for Ethnobotanical Education, Research and Services, Barcelona, Spain.
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Stein CA, Penn A, Van Hope S, Dorsen CG, Mangini M. The Pharmacology and Clinical Applications of Psychedelic Medicines Within Midwifery Practice. J Midwifery Womens Health 2022; 67:373-383. [PMID: 35522087 PMCID: PMC9322528 DOI: 10.1111/jmwh.13371] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 04/04/2022] [Accepted: 04/07/2022] [Indexed: 11/28/2022]
Abstract
The research and use of psychedelic medicines to treat common mental health disorders has increased substantially in the past 2 decades. At the same time, knowledge is relatively uncommon among midwives regarding (1) the relative benefits of psychedelic-assisted therapy, (2) best practices associated with the delivery of psychedelic-assisted therapy, and (3) responsible integration of this potentially useful intervention into mental health treatment plans. The purpose of this review is to describe current applications of psychedelic medicines to treat common mental health disorders, to describe the current legal status of these medicines used in this context, and to explore the potential for midwifery practice in this area with further training. This article also addresses the disparities regarding LGBTQIA+ and BIPOC populations in relation to this topic and their historical exclusion from research and treatment access in this field.
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Affiliation(s)
- Cindy A Stein
- California State University Monterey Bay School of Nursing, Seaside, California
| | - Andrew Penn
- University of California at San Francisco School of Nursing, San Francisco, California
| | | | - Caroline G Dorsen
- Division of Advanced Nursing Practice, Rutgers School of Nursing, Newark, New Jersey
| | - Mariavittoria Mangini
- Integral and Transpersonal Psychology Department, California Institute of Integral Studies, San Francisco, California
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James E, Keppler J, L Robertshaw T, Sessa B. N,N-dimethyltryptamine and Amazonian ayahuasca plant medicine. Hum Psychopharmacol 2022; 37:e2835. [PMID: 35175662 PMCID: PMC9286861 DOI: 10.1002/hup.2835] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 01/13/2022] [Accepted: 01/26/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Reports have indicated possible uses of ayahuasca for the treatment of conditions including depression, addictions, post-traumatic stress disorder, anxiety and specific psychoneuroendocrine immune system pathologies. The article assesses potential ayahuasca and N,N-dimethyltryptamine (DMT) integration with contemporary healthcare. The review also seeks to provide a summary of selected literature regarding the mechanisms of action of DMT and ayahuasca; and assess to what extent the state of research can explain reports of unusual phenomenology. DESIGN A narrative review. RESULTS Compounds in ayahuasca have been found to bind to serotonergic receptors, glutaminergic receptors, sigma-1 receptors, trace amine-associated receptors, and modulate BDNF expression and the dopaminergic system. Subjective effects are associated with increased delta and theta oscillations in amygdala and hippocampal regions, decreased alpha wave activity in the default mode network, and stimulations of vision-related brain regions particularly in the visual association cortex. Both biological processes and field of consciousness models have been proposed to explain subjective effects of DMT and ayahuasca, however, the evidence supporting the proposed models is not sufficient to make confident conclusions. Ayahuasca plant medicine and DMT represent potentially novel treatment modalities. CONCLUSIONS Further research is required to clarify the mechanisms of action and develop treatments which can be made available to the general public. Integration between healthcare research institutions and reputable practitioners in the Amazon is recommended.
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Affiliation(s)
- Edward James
- School of Pharmacy and Pharmaceutical SciencesCardiff UniversityCardiffUK
| | | | | | - Ben Sessa
- Centre for NeuropsychopharmacologyDivision of Brain SciencesFaculty of MedicineImperial College LondonLondonUK
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22
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Rossi GN, Dias ICDS, Baker G, Bouso Saiz JC, Dursun SM, Hallak JEC, Dos Santos RG. Ayahuasca, a potentially rapid acting antidepressant: focus on safety and tolerability. Expert Opin Drug Saf 2022; 21:789-801. [PMID: 35301934 DOI: 10.1080/14740338.2022.2054988] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Ayahuasca is a psychedelic brew originally used by indigenous tribes from the Amazon Rainforest and in religious rituals. Pre-clinical and observational studies have demonstrated its possible potential as an antidepressant, and open and placebo-controlled clinical trials corroborated these results. For it to become an approved treatment for depression, its safety and tolerability need to be assessed and documented. AREAS COVERED We have gathered data regarding occurrence of adverse events (AEs) in all reported randomized, placebo-controlled trials with healthy and clinical populations involving ayahuasca administration (n = 108 ayahuasca administrations). We systematically categorized these results, recorded their prevalence and discussed the possible mechanisms related to their emergence. EXPERT OPINION : There were no reports of serious AEs, indicating a relative safety of ayahuasca administration in controlled settings. Most common AEs related to ayahuasca administration included nausea, vomiting, headaches and transient increases in cardiovascular measurements. Ayahuasca research is still in its infancy, especially concerning the absence of large and robust clinical trials to verify its antidepressant effects. Dose standardization, legal prohibition of the possession of its alkaloids and how traditional communities will be compensated if ayahuasca becomes an approved medicine are the biggest obstacles to overcome for its future use in the therapeutic context.
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Affiliation(s)
- Giordano Novak Rossi
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | | | - Glen Baker
- National Institute for Translational Medicine (INCT-TM) CNPq, Brazil.,Department of Psychiatry (Neurochemical Research Unit) and Neuroscience & Mental Health Institute, University of Alberta, Edmonton, Alberta, Canada
| | - José Carlos Bouso Saiz
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.,Research and Services, ICEERS International Center for Ethnobotanical Education ,Barcelona, Spain.,Medical Anthopology Research Center (MARC), Universitat Rovira i Virgili, Tarragona, Spain
| | - Serdar M Dursun
- National Institute for Translational Medicine (INCT-TM) CNPq, Brazil.,Department of Psychiatry (Neurochemical Research Unit) and Neuroscience & Mental Health Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Jaime E C Hallak
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.,National Institute for Translational Medicine (INCT-TM) CNPq, Brazil.,Department of Psychiatry (Neurochemical Research Unit) and Neuroscience & Mental Health Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Rafael G Dos Santos
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.,National Institute for Translational Medicine (INCT-TM) CNPq, Brazil.,Research and Services, ICEERS International Center for Ethnobotanical Education ,Barcelona, Spain
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23
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Bălăeţ M. Psychedelic Cognition—The Unreached Frontier of Psychedelic Science. Front Neurosci 2022; 16:832375. [PMID: 35401088 PMCID: PMC8989050 DOI: 10.3389/fnins.2022.832375] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 01/27/2022] [Indexed: 12/14/2022] Open
Abstract
Psychedelic compounds hold the promise of changing the face of neuroscience and psychiatry as we know it. There have been numerous proposals to use them to treat a range of neuropsychiatric conditions such as depression, anxiety, addiction and PTSD; and trials to date have delivered positive results in favor of the novel therapeutics. Further to the medical use, the wider healthy population is gaining interest in these compounds. We see a surge in personal use of psychedelic drugs for reasons not limited to spiritual enhancement, improved productivity, aiding the management of non-pathological anxiety and depression, and recreational interests. Notably, microdosing—the practice of taking subacute doses of psychedelic compounds—is on the rise. Our knowledge about the effects of psychedelic compounds, however, especially in naturalistic settings, is still fairly limited. In particular, one of the largest gaps concerns the acute effects on cognition caused by psychedelics. Studies carried out to date are riddled with limitations such as having disparate paradigms, small sample sizes, and insufficient breadth of testing on both unhealthy and healthy volunteers. Moreover, the studies are majoritarily limited to laboratory settings and do not assess the effects at multiple dosages within the same paradigm nor at various points throughout the psychedelic experience. This review aims to summarize the studies to date in relation to how psychedelics acutely affect different domains of cognition. In the pursuit of illuminating the current limitations and offering long-term, forward-thinking solutions, this review compares and contrasts findings related to how psychedelics impact memory, attention, reasoning, social cognition, and creativity.
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24
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Nižnanský Ľ, Nižnanská Ž, Kuruc R, Szórádová A, Šikuta J, Zummerová A. Ayahuasca as a Decoction Applied to Human: Analytical Methods, Pharmacology and Potential Toxic Effects. J Clin Med 2022; 11:1147. [PMID: 35207420 PMCID: PMC8880227 DOI: 10.3390/jcm11041147] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/28/2022] [Accepted: 02/19/2022] [Indexed: 02/06/2023] Open
Abstract
Ahyahuasca is a term commonly used to describe a decoction prepared by cooking the bark or crushed stems of the liana Banisteriopsis caapi (contains β-carbolines) alone or in combination with other plants, most commonly leaves of the shrub Psychotria viridis (contains N,N-dimethyltryptamine-DMT). More than 100 different plants can serve as sources of β-carbolines and DMT, which are the active alkaloids of this decoction, and therefore it is important to know the most accurate composition of the decoction, especially when studying the pharmacology of this plant. The aim was to summarize the latest sensitive methods used in the analysis of the composition of the beverage itself and the analysis of various biological matrices. We compared pharmacokinetic parameters in all of the studies where decoction of ayahuasca was administered and where its composition was known, whereby minimal adverse effects were observed. The therapeutic benefit of this plant is still unclear in the scientific literature, and side effects occur probably on the basis of pre-existing psychiatric disorder. We also described toxicological risks and clinical benefits of ayahuasca intake, which meant that the concentrations of active alkaloids in the decoction or in the organism, often not determined in publications, were required for sufficient evaluation of its effect on the organism. We did not find any post-mortem study, in which the toxicological examination of biological materials together with the autopsy findings would suggest potential lethality of this plant.
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Affiliation(s)
- Ľuboš Nižnanský
- Department of Forensic Medicine and Toxicology, Health Care Surveillance Authority, Antolská 11, 85107 Bratislava, Slovakia; (R.K.); (A.S.); (J.Š.); (A.Z.)
- Institute of Forensic Medicine, Faculty of Medicine, Comenius University in Bratislava, Sasinková 4, 81108 Bratislava, Slovakia
| | - Žofia Nižnanská
- Department of Forensic Medicine and Toxicology, Health Care Surveillance Authority, Antolská 11, 85107 Bratislava, Slovakia; (R.K.); (A.S.); (J.Š.); (A.Z.)
- Institute of Forensic Medicine, Faculty of Medicine, Comenius University in Bratislava, Sasinková 4, 81108 Bratislava, Slovakia
- Department of Analytical Chemistry, Faculty of Natural Sciences, Comenius University in Bratislava, Mlynská Dolina, Ilkovičova 6, 84215 Bratislava, Slovakia
| | - Roman Kuruc
- Department of Forensic Medicine and Toxicology, Health Care Surveillance Authority, Antolská 11, 85107 Bratislava, Slovakia; (R.K.); (A.S.); (J.Š.); (A.Z.)
- Institute of Forensic Medicine, Faculty of Medicine, Comenius University in Bratislava, Sasinková 4, 81108 Bratislava, Slovakia
| | - Andrea Szórádová
- Department of Forensic Medicine and Toxicology, Health Care Surveillance Authority, Antolská 11, 85107 Bratislava, Slovakia; (R.K.); (A.S.); (J.Š.); (A.Z.)
- Institute of Forensic Medicine, Faculty of Medicine, Comenius University in Bratislava, Sasinková 4, 81108 Bratislava, Slovakia
| | - Ján Šikuta
- Department of Forensic Medicine and Toxicology, Health Care Surveillance Authority, Antolská 11, 85107 Bratislava, Slovakia; (R.K.); (A.S.); (J.Š.); (A.Z.)
- Institute of Forensic Medicine, Faculty of Medicine, Comenius University in Bratislava, Sasinková 4, 81108 Bratislava, Slovakia
| | - Anežka Zummerová
- Department of Forensic Medicine and Toxicology, Health Care Surveillance Authority, Antolská 11, 85107 Bratislava, Slovakia; (R.K.); (A.S.); (J.Š.); (A.Z.)
- Institute of Forensic Medicine, Faculty of Medicine, Comenius University in Bratislava, Sasinková 4, 81108 Bratislava, Slovakia
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25
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Administration of N,N-dimethyltryptamine (DMT) in psychedelic therapeutics and research and the study of endogenous DMT. Psychopharmacology (Berl) 2022; 239:1749-1763. [PMID: 35064294 PMCID: PMC8782705 DOI: 10.1007/s00213-022-06065-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 01/11/2022] [Indexed: 12/20/2022]
Abstract
As with all drugs, the route, form, and/or dose of a substance administered or applied can play a defining role in its overall pharmacology and use as a therapeutic. This review will focus on these factors as they relate to the psychedelic N,N-dimethyltryptamine (DMT). It will examine the positive and negative aspects of different formulations and routes of administration of DMT and the observed effects from such administrations in the form of ayahuasca teas; oral "pharmahuasca"; injections by intravenous (IV) and intramuscular (IM) routes; inhalation, insufflation; and other routes; and high-dose, low-dose, and "micro-dose" effects. The review will consider possible oral route of administration alternatives that would not require concomitant use of a monoamine oxidase inhibitor. The review will then address the current research findings for DMT from in vivo and in vitro studies as well as the possibility that these findings may be revealing the role of endogenous DMT in normal brain function.
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26
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Daldegan-Bueno D, Révész D, Morais PR, Barbosa PCR, Maia LO. Psychosocial and Drug Use Assessment of Regular vs. Non-Regular Ayahuasca Users in a Brazilian Sample: a Web-Based Survey. Subst Use Misuse 2022; 57:1072-1081. [PMID: 35466853 DOI: 10.1080/10826084.2022.2063896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Background: Preliminary evidence suggests that long-term ayahuasca use is associated with better psychosocial outcomes and less drug use; however, available data on the association between ayahuasca intake frequency and psychosocial outcomes is limited. Objectives: We sought to characterize and investigate the association of regular ayahuasca use, as compared to non-regular use, on licit (alcohol and tobacco) and illicit (cannabis, psychostimulants, psychedelics, and non-medical opioids) drug use and psychosocial outcomes. Methods: An online-based cross-sectional survey was taken among people who use ayahuasca in Brazil assessing sociodemographic, drug and ayahuasca use, anxiety and depression (HAD-S), intrinsic religiosity (IRI), negative and positive affects (PANAS), satisfaction with life (SWLS), and five quality of life domains (WHOQOL-Brief). Multivariate regressions for each psychosocial outcome and drug use were performed comparing regular to non-regular ayahuasca users while correcting for sociodemographic variables. Results: A total of 286 valid answers were retrieved, divided into people with regular (n = 101) and non-regular (n = 185) ayahuasca use. Groups had similar sociodemographic profiles and lifetime use of drugs. In the multivariate analysis, regular use of ayahuasca was associated with lower anxiety (B: -0.97), negative affect (B: -2.62), general (B: 0.22) and physical (B: 0.17) quality of life, higher intrinsic religiosity scores (B: 4.16), and less past-month licit (OR = 0.30) and illicit (OR = 0.49) use of substances. Conclusions: Our results show that ceremonial regular ayahuasca compared to non-regular use is associated with better psychosocial and mental health outcomes and less drug use. Studies with repeated ayahuasca administration and extended follow-ups are essential to clarify the nature of ayahuasca's therapeutic effects and to guide future clinical research.
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Affiliation(s)
- Dimitri Daldegan-Bueno
- Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), School of Medical Sciences, University of Campinas, Campinas, Brazil.,Centre for Applied Research in Mental Health and Addiction, Faculty of Health Sciences, Simon Fraser University, Vancouver, Canada
| | | | - Paulo Rogério Morais
- Department of Psychology, Federal University of Rondônia, Porto Velho, Brazil.,Observatory of Violence, Health and Work (OBSAT), Federal University of Rondônia, Porto Velho, Brazil
| | | | - Lucas Oliveira Maia
- Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), School of Medical Sciences, University of Campinas, Campinas, Brazil
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27
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Sousa TR, Rema J, Machado S, Novais F. Psychedelics and hallucinogens in Psychiatry: finding new pharmacological targets. Curr Top Med Chem 2021; 22:1250-1260. [PMID: 34852736 DOI: 10.2174/1568026621666211201145800] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 10/31/2021] [Accepted: 11/01/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND The therapeutic options for neurobehavioral disorders are still limited, and in many cases, they lack a satisfactory balance between efficacy and side effects. OBJECTIVE This work aims to review current evidence regarding the potential contribution of psychedelics and hallucinogens to the discovery of new drugs for treating different psychiatric disorders. DISCUSSION Ayahuasca/N,N-dimethyltryptamine (DMT), lysergic acid diethylamide (LSD), and psilocybin have evidence supporting their use in depression, and psilocybin and ayahuasca have also shown good results in treatment-resistant depression. In randomized controlled trials (RCTs) conducted with anxious patients, there were symptomatic improvements with psilocybin and LSD. Psilocybin diminished Yale-Brown Obsessive Compulsive Scale (Y-BOCS) scores in a small obsessive-compulsive disorder (OCD) sample. The evidence is less robust regarding substance use disorders, but it suggests a possible role for LSD and psilocybin in alcohol use disorders and for psilocybin in tobacco addiction. In a clinical setting, these substances seem to be safe and well-tolerated. Their mechanisms of action are not fully elucidated, but there seems to be a preponderant role of 5-hydroxytryptamine (5HT) 2A agonism, as well as connectivity changes within the default mode network (DMN) and amygdala and some other molecular modifications. CONCLUSION The studies underlying the conclusions have small samples and are heterogeneous in their methods. However, the results suggest that the use of psychedelics and hallucinogens could be considered in some disorders. More studies are needed to reinforce their evidence as potential new drugs.
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Affiliation(s)
- Teresa Reynolds Sousa
- Psychiatry and Mental Health Department, North Lisbon Hospital Centre, Lisbon. Portugal
| | - João Rema
- Psychiatry and Mental Health Department, North Lisbon Hospital Centre, Lisbon. Portugal
| | - Sergio Machado
- Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria. Brazil
| | - Filipa Novais
- Psychiatry and Mental Health Department, North Lisbon Hospital Centre, Lisbon. Portugal
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28
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Houle SKD, Evans D, Carter CA, Schlagenhauf P. Ayahuasca and the traveller: A scoping review of risks and possible benefits. Travel Med Infect Dis 2021; 44:102206. [PMID: 34785376 DOI: 10.1016/j.tmaid.2021.102206] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 11/10/2021] [Accepted: 11/10/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND Ayahuasca is a psychotropic drink made from the Amazonian vine Banisteriopsis caapi. Active components include beta-carboline alkaloids and the hallucinogen N-N-dimethyltryptamine (DMT). This review aimed to identify and summarize the literature on the safety and effectiveness of ayahuasca among recreational users. METHOD A comprehensive literature search was done on November 1, 2019 in the following six databases: PubMed(MEDLINE), Ovid Embase, Ovid International Pharmaceutical Abstracts, LILACS, Scopus, and Web of Science. Articles were included if they were original research published in English, Spanish, or Portuguese, among human participants using oral ayahuasca for neuropsychiatric effects. Chemical or pharmacological analyses, brain imaging studies, and studies examining the use of ayahuasca within a religious context were excluded. RESULTS 5750 unique titles were identified through the database searches, with an additional 19 titles identified through manual searches. Ultimately, 39 met all the criteria for inclusion. Articles were organized into 4 themes: (1) Case reports and case series; (2) The use of ayahuasca for depression or grief; (3) The use of ayahuasca and other psychiatric or neuropsychological outcomes; and (4) Studies examining ayahuasca use and physiologic outcomes. Ayahuasca use is associated with a risk of both psychiatric and non-psychiatric events including hallucinations, agitation or aggression, vomiting, seizure, and rhabdomyolysis. Five fatalities have been reported in the literature following ayahuasca use. Open-label studies assessing ayahuasca use in depression found favorable results persisting across 21 days. Ayahuasca was also found to influence the MINDSENS scale for mindfulness, with mixed results observed for impact of ayahuasca on cognitive function and creativity, and benefits observed for measures of self-acceptance and overall wellbeing. CONCLUSIONS To date, evidence on benefits for the management of depression, anxiety, and other mental health disorders is mixed, with some evidence suggesting improvements in mindfulness measures and creativity that are generally short-lived, and multiple case reports suggesting the potential for harm and interactions.
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Affiliation(s)
| | - Derek Evans
- School of Pharmacy, Keck Graduate Institute, United States
| | | | - Patricia Schlagenhauf
- University of Zürich Centre for Travel Medicine, WHO Collaborating Centre for Travellers' Health, Epidemiology Biostatistics and Prevention Institute, Zürich, Switzerland
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29
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Hong CCH, Fallon JH, Friston KJ. fMRI Evidence for Default Mode Network Deactivation Associated with Rapid Eye Movements in Sleep. Brain Sci 2021; 11:brainsci11111528. [PMID: 34827529 PMCID: PMC8615877 DOI: 10.3390/brainsci11111528] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/12/2021] [Accepted: 11/16/2021] [Indexed: 11/25/2022] Open
Abstract
System-specific brain responses—time-locked to rapid eye movements (REMs) in sleep—are characteristically widespread, with robust and clear activation in the primary visual cortex and other structures involved in multisensory integration. This pattern suggests that REMs underwrite hierarchical processing of visual information in a time-locked manner, where REMs index the generation and scanning of virtual-world models, through multisensory integration in dreaming—as in awake states. Default mode network (DMN) activity increases during rest and reduces during various tasks including visual perception. The implicit anticorrelation between the DMN and task-positive network (TPN)—that persists in REM sleep—prompted us to focus on DMN responses to temporally-precise REM events. We timed REMs during sleep from the video recordings and quantified the neural correlates of REMs—using functional MRI (fMRI)—in 24 independent studies of 11 healthy participants. A reanalysis of these data revealed that the cortical areas exempt from widespread REM-locked brain activation were restricted to the DMN. Furthermore, our analysis revealed a modest temporally-precise REM-locked decrease—phasic deactivation—in key DMN nodes, in a subset of independent studies. These results are consistent with hierarchical predictive coding; namely, permissive deactivation of DMN at the top of the hierarchy (leading to the widespread cortical activation at lower levels; especially the primary visual cortex). Additional findings indicate REM-locked cerebral vasodilation and suggest putative mechanisms for dream forgetting.
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Affiliation(s)
- Charles Chong-Hwa Hong
- Patuxent Institution, Correctional Mental Health Center—Jessup, Jessup, MD 20794, USA
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University, Baltimore, MD 21205, USA
- Correspondence: ; Tel.: +1-410-596-1956
| | - James H. Fallon
- Department of Anatomy and Neurobiology, University of California, Irvine, CA 92697, USA;
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA 92697, USA
| | - Karl J. Friston
- The Well Come Centre for Human Neuroimaging, Institute of Neurology, University College London, London WC1N 3AR, UK;
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30
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van Oorsouw KI, Uthaug MV, Mason NL, Broers NJ, Ramaekers JG. Sub-acute and long-term effects of ayahuasca on mental health and well-being in healthy ceremony attendants: A replication study. JOURNAL OF PSYCHEDELIC STUDIES 2021. [DOI: 10.1556/2054.2021.00174] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Abstract
Background and aims
There is a growing body of evidence suggesting that the psychedelic plant tea, ayahuasca, holds therapeutic potential. Uthaug et al. (2018) demonstrated that a single dose of ayahuasca improved mental health sub-acutely and 4-weeks post-ceremony in healthy participants. The present study aimed to replicate and extend these findings. A first objective was to assess the sub-acute and long-term effects of ayahuasca on mental health and well-being in first-time and experienced users. A second aim was to extend the assessment of altered states of consciousness and how they relate to changes in mental health.
Method
Ayahuasca ceremony attendants (N = 73) were assessed before, the day after, and four weeks following the ceremony.
Results
We replicated the reduction in self-reported stress 4-weeks post ceremony, but, in contrast, found no reduction in depression. Also, increased satisfaction with life and awareness the day after the ceremony, and its return to baseline 4 weeks later, were replicated. New findings were: reduced ratings of anxiety and somatization, and increased levels of non-judging 4-weeks post-ceremony. We replicated the relation between altered states of consciousness (e.g., experienced ego dissolution during the ceremony) and mental health outcomes sub-acutely. The effects of ayahuasca did not differ between experienced and first-time users.
Conclusion
Partly in line with previous findings, ayahuasca produces long-term improvements in affect in non-clinical users. Furthermore, sub-acute mental health ratings are related to the intensity of the psychedelic experience. Although findings replicate and highlight the therapeutic potential of ayahuasca, this needs to be confirmed in placebo-controlled studies.
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Affiliation(s)
- Kim I. van Oorsouw
- 1 Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, The Netherlands
| | - Malin V. Uthaug
- 1 Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, The Netherlands
- 2 Centre for Psychedelic Research, Department of Brain Sciences, Faculty of Medicine, Imperial College, London, UK
| | - Natasha L. Mason
- 3 Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, The Netherlands
| | - Nick J. Broers
- 4 Department of Methodology and Statistics, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Johannes G. Ramaekers
- 3 Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, The Netherlands
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31
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Reiff CM, Richman EE, Nemeroff CB, Carpenter LL, Widge AS, Rodriguez CI, Kalin NH, McDonald WM. Psychedelics and Psychedelic-Assisted Psychotherapy. FOCUS: JOURNAL OF LIFE LONG LEARNING IN PSYCHIATRY 2021; 19:95-115. [PMID: 34483775 DOI: 10.1176/appi.focus.19104] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Revised: 08/10/2019] [Accepted: 11/12/2019] [Indexed: 11/30/2022]
Abstract
(Reprinted with permission from The American Journal of Psychiatry 2020; 177:391-410).
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Affiliation(s)
- Collin M Reiff
- Department of Psychiatry, New York University School of Medicine, New York (Reiff); Department of Psychiatry and Human Behavior, Emory University School of Medicine, Atlanta (Richman, McDonald); Department of Psychiatry, Dell Medical School and the Institute for Early Life Adversity Research, University of Texas at Austin (Nemeroff); Department of Psychiatry and Human Behavior, Butler Hospital, Brown University, Providence, R.I. (Carpenter); Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis (Widge); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, Calif., and Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Rodriguez); Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison (Kalin)
| | - Elon E Richman
- Department of Psychiatry, New York University School of Medicine, New York (Reiff); Department of Psychiatry and Human Behavior, Emory University School of Medicine, Atlanta (Richman, McDonald); Department of Psychiatry, Dell Medical School and the Institute for Early Life Adversity Research, University of Texas at Austin (Nemeroff); Department of Psychiatry and Human Behavior, Butler Hospital, Brown University, Providence, R.I. (Carpenter); Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis (Widge); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, Calif., and Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Rodriguez); Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison (Kalin)
| | - Charles B Nemeroff
- Department of Psychiatry, New York University School of Medicine, New York (Reiff); Department of Psychiatry and Human Behavior, Emory University School of Medicine, Atlanta (Richman, McDonald); Department of Psychiatry, Dell Medical School and the Institute for Early Life Adversity Research, University of Texas at Austin (Nemeroff); Department of Psychiatry and Human Behavior, Butler Hospital, Brown University, Providence, R.I. (Carpenter); Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis (Widge); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, Calif., and Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Rodriguez); Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison (Kalin)
| | - Linda L Carpenter
- Department of Psychiatry, New York University School of Medicine, New York (Reiff); Department of Psychiatry and Human Behavior, Emory University School of Medicine, Atlanta (Richman, McDonald); Department of Psychiatry, Dell Medical School and the Institute for Early Life Adversity Research, University of Texas at Austin (Nemeroff); Department of Psychiatry and Human Behavior, Butler Hospital, Brown University, Providence, R.I. (Carpenter); Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis (Widge); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, Calif., and Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Rodriguez); Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison (Kalin)
| | - Alik S Widge
- Department of Psychiatry, New York University School of Medicine, New York (Reiff); Department of Psychiatry and Human Behavior, Emory University School of Medicine, Atlanta (Richman, McDonald); Department of Psychiatry, Dell Medical School and the Institute for Early Life Adversity Research, University of Texas at Austin (Nemeroff); Department of Psychiatry and Human Behavior, Butler Hospital, Brown University, Providence, R.I. (Carpenter); Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis (Widge); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, Calif., and Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Rodriguez); Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison (Kalin)
| | - Carolyn I Rodriguez
- Department of Psychiatry, New York University School of Medicine, New York (Reiff); Department of Psychiatry and Human Behavior, Emory University School of Medicine, Atlanta (Richman, McDonald); Department of Psychiatry, Dell Medical School and the Institute for Early Life Adversity Research, University of Texas at Austin (Nemeroff); Department of Psychiatry and Human Behavior, Butler Hospital, Brown University, Providence, R.I. (Carpenter); Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis (Widge); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, Calif., and Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Rodriguez); Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison (Kalin)
| | - Ned H Kalin
- Department of Psychiatry, New York University School of Medicine, New York (Reiff); Department of Psychiatry and Human Behavior, Emory University School of Medicine, Atlanta (Richman, McDonald); Department of Psychiatry, Dell Medical School and the Institute for Early Life Adversity Research, University of Texas at Austin (Nemeroff); Department of Psychiatry and Human Behavior, Butler Hospital, Brown University, Providence, R.I. (Carpenter); Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis (Widge); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, Calif., and Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Rodriguez); Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison (Kalin)
| | - William M McDonald
- Department of Psychiatry, New York University School of Medicine, New York (Reiff); Department of Psychiatry and Human Behavior, Emory University School of Medicine, Atlanta (Richman, McDonald); Department of Psychiatry, Dell Medical School and the Institute for Early Life Adversity Research, University of Texas at Austin (Nemeroff); Department of Psychiatry and Human Behavior, Butler Hospital, Brown University, Providence, R.I. (Carpenter); Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis (Widge); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, Calif., and Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Rodriguez); Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison (Kalin)
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Ayahuasca Improves Self-perception of Speech Performance in Subjects With Social Anxiety Disorder: A Pilot, Proof-of-Concept, Randomized, Placebo-Controlled Trial. J Clin Psychopharmacol 2021; 41:540-550. [PMID: 34166299 DOI: 10.1097/jcp.0000000000001428] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Ayahuasca is a classic hallucinogen with anxiolytic and antidepressive properties. Anecdotal evidence also suggests that it improves performance (eg, singing, speech). This controlled trial assessed the effects of ayahuasca on speech performance and anxiety in individuals with social anxiety disorder. METHODS Seventeen volunteers with social anxiety disorder participated in a pilot, proof-of-concept, randomized, parallel-group trial. Self-perception of performance during a public-speaking test was assessed with the Self-statements During Public Speaking Scale primary outcome). Secondary outcomes included anxiety/subjective effects (Visual Analog Mood Scale; Bodily Symptoms Scale), recognition of emotions in facial expressions (REFE), tolerability measures (cardiovascular measures, self-reports), and brain-derived neurotrophic factor plasma levels. Effects on anxiety and REFE were assessed again 7, 14, and 21 days postdrug. FINDINGS Compared with placebo, ayahuasca significantly improved self-perception of speech performance (Self-statements During Public Speaking Scale) and increased somatic symptoms (Bodily Symptoms Scale). There was also a significant time × group interaction in the cognitive deterioration Visual Analog Mood Scale factor and a significant effect of time in the REFE task, especially in reaction time. Other measures were not significantly modified. Ayahuasca was well tolerated, producing mainly nausea, gastrointestinal discomfort, and vomiting. CONCLUSIONS Ayahuasca improved self-perception of speech performance in socially anxious individuals. These effects occurred independent of task-related anxiety and REFE, suggesting that ayahuasca could specifically improve the cognitive aspect of speech performance. Further studies should try to unveil the mechanisms involved in the effects of ayahuasca and to better understand its effects on anxiety.
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Dos Santos RG, Hallak JEC. Ayahuasca, an ancient substance with traditional and contemporary use in neuropsychiatry and neuroscience. Epilepsy Behav 2021; 121:106300. [PMID: 31182391 DOI: 10.1016/j.yebeh.2019.04.053] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Revised: 04/11/2019] [Accepted: 04/27/2019] [Indexed: 01/12/2023]
Abstract
Ayahuasca is a botanical hallucinogenic preparation traditionally used for ritual and therapeutic purposes by native populations of the Northwestern Amazon. In the last decades, ayahuasca use has spread to Europe, the United States, Asia, and Africa, and interest in the possible therapeutic uses of ayahuasca for treating anxiety and mood disorder and substance-use disorders has increased both among the general public and the scientific community. Indeed, preclinical, observational, and preliminary clinical studies have corroborated some of these findings. In the present article, we present an overview of these studies and highlight the current uses of ayahuasca in neuroscience, such as a tool in the investigation of the neural basis of introspection and other complex cognitive processes.
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Affiliation(s)
- Rafael Guimarães Dos Santos
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil; National Institute for Translational Medicine (INCT-TM), CNPq, Ribeirão Preto, Brazil.
| | - Jaime Eduardo Cecilio Hallak
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil; National Institute for Translational Medicine (INCT-TM), CNPq, Ribeirão Preto, Brazil
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Artin H, Zisook S, Ramanathan D. How do serotonergic psychedelics treat depression: The potential role of neuroplasticity. World J Psychiatry 2021; 11:201-214. [PMID: 34168967 PMCID: PMC8209538 DOI: 10.5498/wjp.v11.i6.201] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 04/07/2021] [Accepted: 05/20/2021] [Indexed: 02/06/2023] Open
Abstract
Depression is a common mental disorder and one of the leading causes of disability around the world. Monoaminergic antidepressants often take weeks to months to work and are not effective for all patients. This has led to a search for a better understanding of the pathogenesis of depression as well as to the development of novel antidepressants. One such novel antidepressant is ketamine, which has demonstrated both clinically promising results and contributed to new explanatory models of depression, including the potential role of neuroplasticity in depression. Early clinical trials are now showing promising results of serotonergic psychedelics for depression; however, their mechanism of action remains poorly understood. This paper seeks to review the effect of depression, classic antidepressants, ketamine, and serotonergic psychedelics on markers of neuroplasticity at a cellular, molecular, electrophysiological, functional, structural, and psychological level to explore the potential role that neuroplasticity plays in the treatment response of serotonergic psychedelics.
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Affiliation(s)
- Hewa Artin
- Department of Psychiatry, UC San Diego, La Jolla, CA 92093, United States
| | - Sidney Zisook
- Department of Psychiatry, UC San Diego, San Diego, CA 92093, United States
| | - Dhakshin Ramanathan
- Department of Psychiatry, VA San Diego Healthcare System, San Diego, CA 92161, United States
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O'Shaughnessy DM, Berlowitz I. Amazonian Medicine and the Psychedelic Revival: Considering the "Dieta". Front Pharmacol 2021; 12:639124. [PMID: 34149407 PMCID: PMC8210416 DOI: 10.3389/fphar.2021.639124] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 02/22/2021] [Indexed: 12/17/2022] Open
Abstract
Background: In Peruvian Amazonian medicine, plant diets (dietas) are a fundamental and highly flexible technique with a variety of uses: from treating and preventing illness, to increasing strength and resilience, to rites of passage, to learning even medicine itself. Many of the plants used in diets are psychoactive; for example, one now well-known plant that can be dieted is Banisteriopsis caapi—the vine also used in the psychoactive brew ayahuasca. The use of ayahuasca has attracted increasing clinical attention towards Amazonian medicine in recent decades, and much work has focused on the potent DMT-containing ayahuasca brew, thus placing the tradition within the purview of psychedelic science. Aims: In comparison to ayahuasca, the properties of diets have been studied less often. Our work draws on data from Amazonian healers to examine plant diets as medical practices, while also considering their fit within the “set and setting framework” that is central to psychedelic research. We argue that the framework is not sufficiently broad for understanding diets, and thus the investigation aimed to expand the conceptual field of Amazonian medicine, particularly in the context of a renewed psychedelic science and its theoretical concepts. Design: We used qualitative data from interviews with Amazonian healers, applying a thematic analysis and contrasting findings with the available literature. Setting: Interviews were conducted in various locations in the San Martín province of Peru between 2015 and 2017. Participants: We selected and interviewed eight healers who had been extensively trained in traditional Amazonian medicine. Measures: Semi-structured interviews were used to gain insight into the healers’ personal experiences with plant diets. Conclusions: Diets are complex but understudied medical practices that should not be explained by reference to pharmacology or psychology only. Intercultural and interdisciplinary research programmes are called for in order to not only better understand plant diets, but traditional Amazonian medicine on the whole.
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Affiliation(s)
- David M O'Shaughnessy
- Department of Psychology, University of California, Berkeley, Berkeley, CA, United States
| | - Ilana Berlowitz
- Faculty of Medicine, University of Zurich, Zurich, Switzerland.,Department of Psychology, University of Fribourg, Fribourg, Switzerland
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Psychoactive Substances of Natural Origin: Toxicological Aspects, Therapeutic Properties and Analysis in Biological Samples. Molecules 2021; 26:molecules26051397. [PMID: 33807728 PMCID: PMC7961374 DOI: 10.3390/molecules26051397] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 02/28/2021] [Accepted: 03/02/2021] [Indexed: 12/14/2022] Open
Abstract
The consumption of new psychoactive substances (NPSs) has been increasing, and this problem affects several countries worldwide. There is a class of NPSs of natural origin, consisting of plants and fungi, which have a wide range of alkaloids, responsible for causing relaxing, stimulating or hallucinogenic effects. The consumption of some of these substances is prompted by religious beliefs and cultural reasons, making the legislation very variable or even ambiguous. However, the abusive consumption of these substances can present an enormous risk to the health of the individuals, since their metabolism and effects are not yet fully known. Additionally, NPSs are widely spread over the internet, and their appearance is very fast, which requires the development of sophisticated analytical methodologies, capable of detecting these compounds. Thus, the objective of this work is to review the toxicological aspects, traditional use/therapeutic potential and the analytical methods developed in biological matrices in twelve plant specimens (Areca catechu, Argyreia nervosa, Ayahuasca, Catha edulis, Datura stramonium, Lophophora williamsii, Mandragora officinarum, Mitragyna speciosa, Piper methysticum Forst, Psilocybe, Salvia divinorum and Tabernanthe iboga).
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Andersen KAA, Carhart-Harris R, Nutt DJ, Erritzoe D. Therapeutic effects of classic serotonergic psychedelics: A systematic review of modern-era clinical studies. Acta Psychiatr Scand 2021; 143:101-118. [PMID: 33125716 DOI: 10.1111/acps.13249] [Citation(s) in RCA: 121] [Impact Index Per Article: 40.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 10/05/2020] [Accepted: 10/22/2020] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To conduct a systematic review of modern-era (post-millennium) clinical studies assessing the therapeutic effects of serotonergic psychedelics drugs for mental health conditions. Although the main focus was on efficacy and safety, study characteristics, duration of antidepressants effects across studies, and the role of the subjective drug experiences were also reviewed and presented. METHOD A systematic literature search (1 Jan 2000 to 1 May 2020) was conducted in PubMed and PsychINFO for studies of patients undergoing treatment with a serotonergic psychedelic. RESULTS Data from 16 papers, representing 10 independent psychedelic-assisted therapy trials (psilocybin = 7, ayahuasca = 2, LSD = 1), were extracted, presented in figures and tables, and narratively synthesized and discussed. Across these studies, a total of 188 patients suffering either cancer- or illness-related anxiety and depression disorders (C/I-RADD), major depressive disorder (MDD), obsessive-compulsive disorder (OCD) or substance use disorder (SUD) were included. The reviewed studies established feasibility and evidence of safety, alongside promising early data of efficacy in the treatment of depression, anxiety, OCD, and tobacco and alcohol use disorders. For a majority of patients, the therapeutic effects appeared to be long-lasting (weeks-months) after only 1 to 3 treatment session(s). All studies were conducted in line with guidelines for the safe conduct of psychedelic therapy, and no severe adverse events were reported. CONCLUSION The resurrection of clinical psychedelic research provides early evidence for treatment efficacy and safety for a range of psychiatric conditions, and constitutes an exciting new treatment avenue in a health area with major unmet needs.
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Affiliation(s)
- Kristoffer A A Andersen
- Centre for Psychedelic Research, Division of Psychiatry, Imperial College London, London, UK.,Centre for Neuropsychopharmacology, Division of Psychiatry, Imperial College London, London, UK
| | - Robin Carhart-Harris
- Centre for Psychedelic Research, Division of Psychiatry, Imperial College London, London, UK
| | - David J Nutt
- Centre for Neuropsychopharmacology, Division of Psychiatry, Imperial College London, London, UK
| | - David Erritzoe
- Centre for Psychedelic Research, Division of Psychiatry, Imperial College London, London, UK.,Centre for Neuropsychopharmacology, Division of Psychiatry, Imperial College London, London, UK
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O'Shaughnessy DM, Berlowitz I, Rodd R, Sarnyai Z, Quirk F. Within-treatment changes in a novel addiction treatment program using traditional Amazonian medicine. Ther Adv Psychopharmacol 2021; 11:2045125320986634. [PMID: 33717431 PMCID: PMC7841703 DOI: 10.1177/2045125320986634] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 11/24/2020] [Indexed: 12/28/2022] Open
Abstract
AIMS The therapeutic use of psychedelics is regaining scientific momentum, but similarly psychoactive ethnobotanical substances have a long history of medical (and other) uses in indigenous contexts. Here we aimed to evaluate patient outcomes in a residential addiction treatment center that employs a novel combination of Western and traditional Amazonian methods. METHODS The study was observational, with repeated measures applied throughout treatment. All tests were administered in the center, which is located in Tarapoto, Peru. Data were collected between 2014 and 2015, and the study sample consisted of 36 male inpatients who were motivated to seek treatment and who entered into treatment voluntarily. Around 58% of the sample was from South America, 28% from Europe, and the remaining 14% from North America. We primarily employed repeated measures on a psychological test battery administered throughout treatment, measuring perceived stress, craving frequency, mental illness symptoms, spiritual well-being, and physical and emotional health. Addiction severity was measured on intake, and neuropsychological performance was assessed in a subsample from intake to at least 2 months into treatment. RESULTS Statistically significant and clinically positive changes were found across all repeated measures. These changes appeared early in the treatment and were maintained over time. Significant improvements were also found for neuropsychological functioning. CONCLUSION These results provide evidence for treatment safety in a highly novel addiction treatment setting, while also suggesting positive therapeutic effects.
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Affiliation(s)
- David M O'Shaughnessy
- College of Medicine and Dentistry, James Cook University, Townsville, QLD 4811, Australia
| | - Ilana Berlowitz
- Department of Psychology, University of Fribourg, Fribourg, Switzerland
| | - Robin Rodd
- Division of Social Sciences, Duke Kunshan University, Kunshan, Jiangsu, China
| | - Zoltán Sarnyai
- Laboratory of Psychiatric Neuroscience, Centre for Molecular Discovery, Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD, Australia
| | - Frances Quirk
- New England Institute of Healthcare Research, Faculty of Medicine and Health, University of New England, Armidale, NSW, Australia
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Alijanpour S, Jafaripour S, Ghasemzadeh Z, Khakpai F, Zarrindast MR. Harmaline potentiates morphine-induced antinociception via affecting the ventral hippocampal GABA-A receptors in mice. Eur J Pharmacol 2020; 893:173806. [PMID: 33345854 DOI: 10.1016/j.ejphar.2020.173806] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 12/06/2020] [Accepted: 12/10/2020] [Indexed: 11/13/2022]
Abstract
Morphine is one of the most effective medications for treatment of pain, but its side effects limit its use. Therefore, identification of new strategies that can enhance morphine-induced antinociception and/or reduce its side effects will help to develop therapeutic approaches for pain relief. Considering antinociceptive efficacy of harmaline and also highlighted the important role of GABA-A receptors in the pain perception, this research aimed to determine whether the ventral hippocampal (vHip) GABA-A receptors are involved in the possible harmaline-induced enhancement of morphine antinociception. To achieve this, vHip regions of adult male mice were bilaterally cannulated and pain sensitivity was measured in a tail-flick apparatus. Intraperitoneally administration of morphine (0, 2, 4 and 6 mg/kg) or harmaline (0, 1.25, 5 and 10 mg/kg) increased the percentage of maximal possible effect (%MPE) and induced antinociception. Interestingly, co-administration of sub-effective doses of harmaline (5 mg/kg) and morphine (2 mg/kg) induced antinociception. Intra-vHip microinjection of muscimol (0, 200 and 300 ng/mice), a GABA-A receptor agonist, enhanced the anti-nociceptive effects of harmaline (2.5 mg/kg)+morphine (2 mg/kg) combination. Microinjection of the same doses of muscimol into the vHip by itself did not alter tail-flick latency. Intra-vHip microinjection of bicuculline (100 ng/mouse), a GABA-A receptor antagonist, did not cause a significant change in MPE%. Bicuculline (60 and 100 ng/mouse, intra-vHip) was administered with the harmaline (5 mg/kg)+morphine (2 mg/kg), and inhibited the potentiating effect of harmaline on morphine response. These findings favor the notion that GABAergic mechanisms in the vHip facilitate harmaline-induced potentiation of morphine response in the tail-flick test in part through GABA-A receptors. These findings shall provide insights and strategies into the development of pain suppressing drugs.
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Affiliation(s)
- Sakineh Alijanpour
- Department of Biology, Faculty of Science, Gonbad Kavous University, Gonbad Kavous, Iran.
| | - Samira Jafaripour
- Department of Biology, North Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Zahra Ghasemzadeh
- Department of Animal Biology, School of Biology, College of Science, University of Tehran, Tehran, Iran
| | - Fatemeh Khakpai
- Cognitive and Neuroscience Research Center (CNRC), Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Mohammad-Reza Zarrindast
- Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran; Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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40
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Bright S, Williams M. Should Australian Psychology Consider Enhancing Psychotherapeutic Interventions with Psychedelic Drugs? A Call for Research. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/ap.12345] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Stephen Bright
- School of Medical and Health Sciences, Edith Cowan University,
- National Drug Research Institute, Curtin University,
| | - Martin Williams
- Monash Institute of Pharmaceutical Sciences, Monash University,
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Gonçalves J, Luís Â, Gradillas A, García A, Restolho J, Fernández N, Domingues F, Gallardo E, Duarte AP. Ayahuasca Beverages: Phytochemical Analysis and Biological Properties. Antibiotics (Basel) 2020; 9:antibiotics9110731. [PMID: 33114334 PMCID: PMC7690887 DOI: 10.3390/antibiotics9110731] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 10/19/2020] [Accepted: 10/22/2020] [Indexed: 12/15/2022] Open
Abstract
Ayahuasca is a psychoactive beverage, originally consumed by indigenous Amazon tribes, of which consumption has been increasing worldwide. The aim of this study was to evaluate the phytochemical profile, as well as the antioxidant, anti-inflammatory and antimicrobial properties of decoctions of four individual plants, a commercial mixture and four mixtures of two individual plants used in the Ayahuasca preparation. For this purpose, a phytochemical characterization was performed, determining the content of flavonoids, total phenolic compounds, and analyzing the phenolic profile. Besides, 48 secondary metabolites were investigated by ultra-high performance liquid chromatography-quadrupole time-of-flight mass spectrometry (UHPLC-Q/TOF-MS) and their concentration estimated with real standards when present. The antioxidant activity was evaluated by both the β-carotene bleaching test and DPPH free radical scavenging assay, and the anti-inflammatory activity was determined by a protein denaturation method. Finally, the antimicrobial properties were evaluated using the disc diffusion assay, resazurin microtiter method, anti-quorum sensing and anti-biofilm activity assays. The obtained results showed that, in general, the samples have a high content of phenolic compounds and flavonoids with noticeable differences, reflecting on remarkable antioxidant and anti-inflammatory activities. Significant antimicrobial properties were also observed, with emphasis on the effect of B. caapi and P. harmala on planktonic and biofilm cells of A. baumannii, inhibiting both the biofilm formation and the production of violacein pigment.
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Affiliation(s)
- Joana Gonçalves
- Centro de Investigação em Ciências da Saúde (CICS-UBI), Universidade da Beira Interior, Av. Infante D. Henrique, 6200-506 Covilhã, Portugal; (J.G.); (J.R.); (F.D.); (A.P.D.)
- Laboratório de Fármaco-Toxicologia, UBI Medical, Universidade da Beira Interior, Estrada Municipal 506, 6200-284 Covilhã, Portugal
| | - Ângelo Luís
- Centro de Investigação em Ciências da Saúde (CICS-UBI), Universidade da Beira Interior, Av. Infante D. Henrique, 6200-506 Covilhã, Portugal; (J.G.); (J.R.); (F.D.); (A.P.D.)
- Laboratório de Fármaco-Toxicologia, UBI Medical, Universidade da Beira Interior, Estrada Municipal 506, 6200-284 Covilhã, Portugal
- Correspondence: (Â.L.); (E.G.); Tel.: +351-275-329-002/3 (Â.L.); +351-275-329-002/3 (E.G.)
| | - Ana Gradillas
- CEMBIO, Center for Metabolomics and Bioanalysis, Facultad de Farmacia, Universidad San Pablo CEU, CEU Universities, Campus Monteprincipe, Boadilla del Monte, 28668 Madrid, Spain; (A.G.); (A.G.)
| | - Antonia García
- CEMBIO, Center for Metabolomics and Bioanalysis, Facultad de Farmacia, Universidad San Pablo CEU, CEU Universities, Campus Monteprincipe, Boadilla del Monte, 28668 Madrid, Spain; (A.G.); (A.G.)
| | - José Restolho
- Centro de Investigação em Ciências da Saúde (CICS-UBI), Universidade da Beira Interior, Av. Infante D. Henrique, 6200-506 Covilhã, Portugal; (J.G.); (J.R.); (F.D.); (A.P.D.)
| | - Nicolás Fernández
- Cátedra de Toxicología y Química Legal, Laboratorio de Asesoramiento Toxicológico Analítico (CENATOXA), Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Junín 956, C1113AAD Buenos Aires, Argentina;
| | - Fernanda Domingues
- Centro de Investigação em Ciências da Saúde (CICS-UBI), Universidade da Beira Interior, Av. Infante D. Henrique, 6200-506 Covilhã, Portugal; (J.G.); (J.R.); (F.D.); (A.P.D.)
| | - Eugenia Gallardo
- Centro de Investigação em Ciências da Saúde (CICS-UBI), Universidade da Beira Interior, Av. Infante D. Henrique, 6200-506 Covilhã, Portugal; (J.G.); (J.R.); (F.D.); (A.P.D.)
- Laboratório de Fármaco-Toxicologia, UBI Medical, Universidade da Beira Interior, Estrada Municipal 506, 6200-284 Covilhã, Portugal
- Correspondence: (Â.L.); (E.G.); Tel.: +351-275-329-002/3 (Â.L.); +351-275-329-002/3 (E.G.)
| | - Ana Paula Duarte
- Centro de Investigação em Ciências da Saúde (CICS-UBI), Universidade da Beira Interior, Av. Infante D. Henrique, 6200-506 Covilhã, Portugal; (J.G.); (J.R.); (F.D.); (A.P.D.)
- Laboratório de Fármaco-Toxicologia, UBI Medical, Universidade da Beira Interior, Estrada Municipal 506, 6200-284 Covilhã, Portugal
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Brito-da-Costa AM, Dias-da-Silva D, Gomes NGM, Dinis-Oliveira RJ, Madureira-Carvalho Á. Toxicokinetics and Toxicodynamics of Ayahuasca Alkaloids N, N-Dimethyltryptamine (DMT), Harmine, Harmaline and Tetrahydroharmine: Clinical and Forensic Impact. Pharmaceuticals (Basel) 2020; 13:ph13110334. [PMID: 33114119 PMCID: PMC7690791 DOI: 10.3390/ph13110334] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 10/16/2020] [Accepted: 10/20/2020] [Indexed: 12/11/2022] Open
Abstract
Ayahuasca is a hallucinogenic botanical beverage originally used by indigenous Amazonian tribes in religious ceremonies and therapeutic practices. While ethnobotanical surveys still indicate its spiritual and medicinal uses, consumption of ayahuasca has been progressively related with a recreational purpose, particularly in Western societies. The ayahuasca aqueous concoction is typically prepared from the leaves of the N,N-dimethyltryptamine (DMT)-containing Psychotria viridis, and the stem and bark of Banisteriopsis caapi, the plant source of harmala alkaloids. Herein, the toxicokinetics and toxicodynamics of the psychoactive DMT and harmala alkaloids harmine, harmaline and tetrahydroharmine, are comprehensively covered, particularly emphasizing the psychological, physiological, and toxic effects deriving from their concomitant intake. Potential therapeutic utility, particularly in mental and psychiatric disorders, and forensic aspects of DMT and ayahuasca are also reviewed and discussed. Following administration of ayahuasca, DMT is rapidly absorbed and distributed. Harmala alkaloids act as potent inhibitors of monoamine oxidase A (MAO-A), preventing extensive first-pass degradation of DMT into 3-indole-acetic acid (3-IAA), and enabling sufficient amounts of DMT to reach the brain. DMT has affinity for a variety of serotonergic and non-serotonergic receptors, though its psychotropic effects are mainly related with the activation of serotonin receptors type 2A (5-HT2A). Mildly to rarely severe psychedelic adverse effects are reported for ayahuasca or its alkaloids individually, but abuse does not lead to dependence or tolerance. For a long time, the evidence has pointed to potential psychotherapeutic benefits in the treatment of depression, anxiety, and substance abuse disorders; and although misuse of ayahuasca has been diverting attention away from such clinical potential, research onto its therapeutic effects has now strongly resurged.
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Affiliation(s)
- Andreia Machado Brito-da-Costa
- Department of Sciences, IINFACTS-Institute of Research and Advanced Training in Health Sciences and Technologies, University Institute of Health Sciences (IUCS), CESPU, CRL, 4585-116 Gandra, Portugal; (A.M.B.-d.-C.); (N.G.M.G.); (Á.M.-C.)
| | - Diana Dias-da-Silva
- Department of Sciences, IINFACTS-Institute of Research and Advanced Training in Health Sciences and Technologies, University Institute of Health Sciences (IUCS), CESPU, CRL, 4585-116 Gandra, Portugal; (A.M.B.-d.-C.); (N.G.M.G.); (Á.M.-C.)
- UCIBIO-REQUIMTE, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal
- Correspondence: (D.D.-d.-S.); (R.J.D.-O.); Tel.: +351-224-157-216 (R.J.D.-O.)
| | - Nelson G. M. Gomes
- Department of Sciences, IINFACTS-Institute of Research and Advanced Training in Health Sciences and Technologies, University Institute of Health Sciences (IUCS), CESPU, CRL, 4585-116 Gandra, Portugal; (A.M.B.-d.-C.); (N.G.M.G.); (Á.M.-C.)
- LAQV-REQUIMTE, Laboratory of Pharmacognosy, Department of Chemistry, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal
| | - Ricardo Jorge Dinis-Oliveira
- Department of Sciences, IINFACTS-Institute of Research and Advanced Training in Health Sciences and Technologies, University Institute of Health Sciences (IUCS), CESPU, CRL, 4585-116 Gandra, Portugal; (A.M.B.-d.-C.); (N.G.M.G.); (Á.M.-C.)
- UCIBIO-REQUIMTE, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal
- Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
- Correspondence: (D.D.-d.-S.); (R.J.D.-O.); Tel.: +351-224-157-216 (R.J.D.-O.)
| | - Áurea Madureira-Carvalho
- Department of Sciences, IINFACTS-Institute of Research and Advanced Training in Health Sciences and Technologies, University Institute of Health Sciences (IUCS), CESPU, CRL, 4585-116 Gandra, Portugal; (A.M.B.-d.-C.); (N.G.M.G.); (Á.M.-C.)
- LAQV-REQUIMTE, Laboratory of Pharmacognosy, Department of Chemistry, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal
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Ona G, Dos Santos RG, Hallak JEC, Bouso JC. Polypharmacology or "Pharmacological Promiscuity" In Psychedelic Research: What Are We Missing? ACS Chem Neurosci 2020; 11:3191-3193. [PMID: 33021777 DOI: 10.1021/acschemneuro.0c00614] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Research with psychedelic drugs has mainly focused on isolated compounds. However, this approach is challenged by the "polypharmacology" paradigm. In this Viewpoint, we suggest that we may be missing something if we do not use the whole product in the case of ayahuasca or Psilocybe mushrooms. After describing how research on psychedelic drugs can be effectively combined with the polypharmacology paradigm, ethical issues are also briefly discussed.
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Affiliation(s)
- Genı́s Ona
- ICEERS − International Center for Ethnobotanical Education, Research, and Services, Barcelona 08015, Spain
- Medical Anthropology Research Center (MARC), Department of Anthropology, Philosophy and Social Work, Universitat Rovira i Virgili, Tarragona 43003, Spain
| | - Rafael G. Dos Santos
- ICEERS − International Center for Ethnobotanical Education, Research, and Services, Barcelona 08015, Spain
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo, Sao Paulo, SP 14049-900, Brazil
- National Institute for Translational Medicine (INCT-TM), CNPq, Porto Alegre 90035-003, Brazil
| | - Jaime E. C. Hallak
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo, Sao Paulo, SP 14049-900, Brazil
- National Institute for Translational Medicine (INCT-TM), CNPq, Porto Alegre 90035-003, Brazil
| | - José Carlos Bouso
- ICEERS − International Center for Ethnobotanical Education, Research, and Services, Barcelona 08015, Spain
- Medical Anthropology Research Center (MARC), Department of Anthropology, Philosophy and Social Work, Universitat Rovira i Virgili, Tarragona 43003, Spain
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Neu P. [Ayahuasca - religion, life-style or drug?]. FORTSCHRITTE DER NEUROLOGIE-PSYCHIATRIE 2020; 88:669-673. [PMID: 32544955 DOI: 10.1055/a-1149-9187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Ayahuasca is a psychoactive drug which has been used by indigenous cultures in the amazonas basin for hundreds of years for medical and religious purpose. Backpackers who came in contact with ayahuasca exported its use in the western world and increased its popularity. By presenting a case report of a patient seeking medical help due to psychotic symptoms after having attended an ayahuasca ritual we give an short overview of pharmacology, legal status, use and side effects of the substance.
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Affiliation(s)
- Peter Neu
- Clinic of Psychiatry and Psychotherapy, Jüdisches Krankenhaus Berlin - Akademisches Lehrkrankenhaus der Charité - Universitätsmedizin Berlin
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Kaasik H, Souza RCZ, Zandonadi FS, Tófoli LF, Sussulini A. Chemical Composition of Traditional and Analog Ayahuasca. J Psychoactive Drugs 2020; 53:65-75. [PMID: 32896230 DOI: 10.1080/02791072.2020.1815911] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Traditional ayahuasca can be defined as a brew made from Amazonian vine Banisteriopsis caapi and Amazonian admixture plants. Ayahuasca is used by indigenous groups in Amazonia, as a sacrament in syncretic Brazilian religions, and in healing and spiritual ceremonies internationally. The study aimed to determine concentrations of the main bio- and psychoactive components of ayahuasca used in different locations and traditions. We collected 102 samples of brews from ayahuasca-using communities. Concentrations of N,N-dimethyltryptamine (DMT), tetrahydroharmine, harmine, and harmaline were determined by ultra-high performance liquid chromatography coupled to tandem mass spectrometry (UHPLC-MS/MS). Qualitative analyses for non-traditional additives (moclobemide, psilocin, yuremamine) were performed by high resolution mass spectrometry. Higher and more variable concentrations of DMT in neoshamanic ayahuasca samples compared to indigenous samples may indicate use of higher and more variable proportions of DMT-containing admixture plants. From European samples, we found two related samples of analog ayahuasca containing moclobemide, psilocin, DMT, yuremamine, and very low concentrations of B. caapi alkaloids. Some analogs of ayahuasca (Peganum harmala, Mimosa tenuiflora) were used in Europe. No analogs were found from Brazil or Santo Daime ceremonies in Europe. We recommend awareness about the constituents of the brew and ethical self-regulation among practitioners of ayahuasca ceremonies.
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Affiliation(s)
- Helle Kaasik
- School of Theology and Religious Studies; and Institute of Physics, University of Tartu, Tartu, Estonia
| | - Rita C Z Souza
- Laboratory of Bioanalytics and Integrated Omics (LaBIOmics), Institute of Chemistry, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Flávia S Zandonadi
- Laboratory of Bioanalytics and Integrated Omics (LaBIOmics), Institute of Chemistry, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Luís Fernando Tófoli
- Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil
| | - Alessandra Sussulini
- Laboratory of Bioanalytics and Integrated Omics (LaBIOmics), Institute of Chemistry, University of Campinas (UNICAMP), Campinas, SP, Brazil
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Altman BR, Mian MN, Earleywine M. The Novelty of Ayahuasca Scale and the prediction of intentions to use. JOURNAL OF PSYCHEDELIC STUDIES 2020. [DOI: 10.1556/2054.2020.00117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
AbstractObjectiveGiven the growing popularity of ayahuasca and other hallucinogens, we sought to identify related expectancies and their role in why people might use this psychoactive brew rather than classic hallucinogens like LSD or psilocybin.MethodExperienced users (N = 139) completed an online survey about their use of hallucinogens (including ayahuasca), how their ayahuasca experiences differed from those with other hallucinogens, as well as their intentions to use hallucinogens (including ayahuasca) in the future.ResultsParticipants expected ayahuasca effects to differ meaningfully from the effects of other hallucinogens in multiple domains. Expected differences involved positive connections to nature (and other people), dramatic (or terrifying) thoughts, high variability of effects, and physical reactions. Intentions to use ayahuasca in the future increased as expectancies for positive connections increased, but decreased as physical reactions increased. One version of the full Novelty of Ayahuasca scale significantly covaried with the likelihood of using ayahuasca over other hallucinogens in the future, while another version did not. This result calls for further work examining how users perceive certain ayahuasca-induced effects.ConclusionsThese findings reveal that expectancies for ayahuasca differ from those for other hallucinogens, and impact an individual's willingness to try the substance again. Understanding these differences might help those who are interested in the therapeutic potential of hallucinogens decide among those available. Future studies might examine how these expectancies predict intentions to use ayahuasca (and other hallucinogens) longitudinally. Comparable approaches could also identify unique expectancies for other hallucinogens to see if those predict a preference for one over others.
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Affiliation(s)
- Brianna R. Altman
- Department of Psychology, University at Albany, State University of New York, Albany, NY, USA
| | - M. N. Mian
- Department of Psychology, University at Albany, State University of New York, Albany, NY, USA
| | - M. Earleywine
- Department of Psychology, University at Albany, State University of New York, Albany, NY, USA
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Pasquini L, Palhano-Fontes F, Araujo DB. Subacute effects of the psychedelic ayahuasca on the salience and default mode networks. J Psychopharmacol 2020; 34:623-635. [PMID: 32255395 DOI: 10.1177/0269881120909409] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND Neuroimaging studies have just begun to explore the acute effects of psychedelics on large-scale brain networks' functional organization. Even less is known about the neural correlates of subacute effects taking place days after the psychedelic experience. This study explores the subacute changes of primary sensory brain networks and networks supporting higher-order affective and self-referential functions 24 hours after a single session with the psychedelic ayahuasca. METHODS We leveraged task-free functional magnetic resonance imaging data 1 day before and 1 day after a randomized placebo-controlled trial exploring the effects of ayahuasca in naïve healthy participants (21 placebo/22 ayahuasca). We derived intra- and inter-network functional connectivity of the salience, default mode, visual, and sensorimotor networks, and assessed post-session connectivity changes between the ayahuasca and placebo groups. Connectivity changes were associated with Hallucinogen Rating Scale scores assessed during the acute effects. RESULTS Our findings revealed increased anterior cingulate cortex connectivity within the salience network, decreased posterior cingulate cortex connectivity within the default mode network, and increased connectivity between the salience and default mode networks 1 day after the session in the ayahuasca group compared to placebo. Connectivity of primary sensory networks did not differ between groups. Salience network connectivity increases correlated with altered somesthesia scores, decreased default mode network connectivity correlated with altered volition scores, and increased salience default mode network connectivity correlated with altered affect scores. CONCLUSION These findings provide preliminary evidence for subacute functional changes induced by the psychedelic ayahuasca on higher-order cognitive brain networks that support interoceptive, affective, and self-referential functions.
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Affiliation(s)
- Lorenzo Pasquini
- Memory and Aging Center, University of California, San Francisco, United States of America
| | | | - Draulio B Araujo
- Brain Institute, Federal University of Rio Grande do Norte, Natal-RN, Brazil
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Orsolini L, Chiappini S, Papanti D, Latini R, Volpe U, Fornaro M, Tomasetti C, Vellante F, De Berardis D. How does ayahuasca work from a psychiatric perspective? Pros and cons of the entheogenic therapy. Hum Psychopharmacol 2020; 35:e2728. [PMID: 32220028 DOI: 10.1002/hup.2728] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 01/13/2020] [Accepted: 02/20/2020] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Ayahuasca is a hallucinogenic plant preparation, traditionally consumed in sacred ceremonies by indigenous North-Westerner Amazonian countries like Colombia, Peru, Brazil, and Ecuador. It is fundamental to carefully balance benefits/risks related to the ayahuasca intake, both during ceremonies and experimental settings. The aim is at evaluating and comparing the potential therapeutic benefits versus health risks related to ayahuasca intake (both acutely and chronically), focusing on its application in psychedelic psychiatry. DESIGN A comprehensive mini overview focusing on psychiatric outcomes following ayahuasca intake both in healthy volunteers and in clinical samples. RESULTS Preclinical, observational, and experimental studies in healthy volunteers as well as in clinical samples suggest that ayahuasca may be beneficial as an antidepressant, emotional regulator, anxiolytic, and antiaddictive drug, by exerting fast-acting and enduring clinical effects. Ayahuasca appears to be safe and well tolerated, nausea and emesis being the most reported and transient side effects. Some findings suggest not to use ayahuasca in bipolar or psychotic patients because of an increased risk of manic switch and/or psychotic onset. CONCLUSIONS Further research should be carried out in randomized, double-blind, placebo-controlled trials, by implementing neuroimaging studies, in order to better evaluate therapeutic potential of ayahuasca in mental disorders.
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Affiliation(s)
- Laura Orsolini
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK.,Department of Clinical Neurosciences/DIMSC, School of Medicine, Section of Psychiatry, Polytechnic University of Marche, Ancona, Italy.,Polyedra, Polyedra Research, Teramo, Italy
| | - Stefania Chiappini
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - Duccio Papanti
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - Roberto Latini
- Neomesia Mental Health, Villa Jolanda Hospital, Maiolati Spontini, Italy
| | - Umberto Volpe
- Department of Clinical Neurosciences/DIMSC, School of Medicine, Section of Psychiatry, Polytechnic University of Marche, Ancona, Italy
| | - Michele Fornaro
- Laboratory of Molecular Psychiatry and Psychopharmacotherapeutics, Section of Psychiatry, Department of Neuroscience, University School of Medicine "Federico II", Naples, Italy
| | - Carmine Tomasetti
- Polyedra, Polyedra Research, Teramo, Italy.,Laboratory of Molecular Psychiatry and Psychopharmacotherapeutics, Section of Psychiatry, Department of Neuroscience, University School of Medicine "Federico II", Naples, Italy.,NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "SS. Annunziata", Giulianova, Italy
| | - Federica Vellante
- Department of Neuroscience, Imaging and Clinical Science, University of "G. D'Annunzio", Chieti, Italy
| | - Domenico De Berardis
- Polyedra, Polyedra Research, Teramo, Italy.,Department of Neuroscience, Imaging and Clinical Science, University of "G. D'Annunzio", Chieti, Italy.,NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini", Teramo, Italy
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Reiff CM, Richman EE, Nemeroff CB, Carpenter LL, Widge AS, Rodriguez CI, Kalin NH, McDonald WM. Psychedelics and Psychedelic-Assisted Psychotherapy. Am J Psychiatry 2020; 177:391-410. [PMID: 32098487 DOI: 10.1176/appi.ajp.2019.19010035] [Citation(s) in RCA: 251] [Impact Index Per Article: 62.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The authors provide an evidenced-based summary of the literature on the clinical application of psychedelic drugs in psychiatric disorders. METHODS Searches of PubMed and PsycINFO via Ovid were conducted for articles in English, in peer-reviewed journals, reporting on "psilocybin," "lysergic acid diethylamide," "LSD," "ayahuasca," "3,4-methylenedioxymethamphetamine," and "MDMA," in human subjects, published between 2007 and July 1, 2019. A total of 1,603 articles were identified and screened. Articles that did not contain the terms "clinical trial," "therapy," or "imaging" in the title or abstract were filtered out. The 161 remaining articles were reviewed by two or more authors. The authors identified 14 articles reporting on well-designed clinical trials investigating the efficacy of lysergic acid diethylamide (LSD), 3,4-methylenedioxymethamphetamine (MDMA), psilocybin, and ayahuasca for the treatment of mood and anxiety disorders, trauma and stress-related disorders, and substance-related and addictive disorders as well as in end-of-life care. RESULTS The most significant database exists for MDMA and psilocybin, which have been designated by the U.S. Food and Drug Administration (FDA) as "breakthrough therapies" for posttraumatic stress disorder (PTSD) and treatment-resistant depression, respectively. The research on LSD and ayahuasca is observational, but available evidence suggests that these agents may have therapeutic effects in specific psychiatric disorders. CONCLUSIONS Randomized clinical trials support the efficacy of MDMA in the treatment of PTSD and psilocybin in the treatment of depression and cancer-related anxiety. The research to support the use of LSD and ayahuasca in the treatment of psychiatric disorders is preliminary, although promising. Overall, the database is insufficient for FDA approval of any psychedelic compound for routine clinical use in psychiatric disorders at this time, but continued research on the efficacy of psychedelics for the treatment of psychiatric disorders is warranted.
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Affiliation(s)
- Collin M Reiff
- Department of Psychiatry, New York University School of Medicine, New York (Reiff); Department of Psychiatry and Human Behavior, Emory University School of Medicine, Atlanta (Richman, McDonald); Department of Psychiatry, Dell Medical School and the Institute for Early Life Adversity Research, University of Texas at Austin (Nemeroff); Department of Psychiatry and Human Behavior, Butler Hospital, Brown University, Providence, R.I. (Carpenter); Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis (Widge); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, Calif., and Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Rodriguez); Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison (Kalin)
| | - Elon E Richman
- Department of Psychiatry, New York University School of Medicine, New York (Reiff); Department of Psychiatry and Human Behavior, Emory University School of Medicine, Atlanta (Richman, McDonald); Department of Psychiatry, Dell Medical School and the Institute for Early Life Adversity Research, University of Texas at Austin (Nemeroff); Department of Psychiatry and Human Behavior, Butler Hospital, Brown University, Providence, R.I. (Carpenter); Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis (Widge); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, Calif., and Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Rodriguez); Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison (Kalin)
| | - Charles B Nemeroff
- Department of Psychiatry, New York University School of Medicine, New York (Reiff); Department of Psychiatry and Human Behavior, Emory University School of Medicine, Atlanta (Richman, McDonald); Department of Psychiatry, Dell Medical School and the Institute for Early Life Adversity Research, University of Texas at Austin (Nemeroff); Department of Psychiatry and Human Behavior, Butler Hospital, Brown University, Providence, R.I. (Carpenter); Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis (Widge); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, Calif., and Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Rodriguez); Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison (Kalin)
| | - Linda L Carpenter
- Department of Psychiatry, New York University School of Medicine, New York (Reiff); Department of Psychiatry and Human Behavior, Emory University School of Medicine, Atlanta (Richman, McDonald); Department of Psychiatry, Dell Medical School and the Institute for Early Life Adversity Research, University of Texas at Austin (Nemeroff); Department of Psychiatry and Human Behavior, Butler Hospital, Brown University, Providence, R.I. (Carpenter); Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis (Widge); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, Calif., and Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Rodriguez); Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison (Kalin)
| | - Alik S Widge
- Department of Psychiatry, New York University School of Medicine, New York (Reiff); Department of Psychiatry and Human Behavior, Emory University School of Medicine, Atlanta (Richman, McDonald); Department of Psychiatry, Dell Medical School and the Institute for Early Life Adversity Research, University of Texas at Austin (Nemeroff); Department of Psychiatry and Human Behavior, Butler Hospital, Brown University, Providence, R.I. (Carpenter); Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis (Widge); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, Calif., and Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Rodriguez); Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison (Kalin)
| | - Carolyn I Rodriguez
- Department of Psychiatry, New York University School of Medicine, New York (Reiff); Department of Psychiatry and Human Behavior, Emory University School of Medicine, Atlanta (Richman, McDonald); Department of Psychiatry, Dell Medical School and the Institute for Early Life Adversity Research, University of Texas at Austin (Nemeroff); Department of Psychiatry and Human Behavior, Butler Hospital, Brown University, Providence, R.I. (Carpenter); Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis (Widge); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, Calif., and Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Rodriguez); Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison (Kalin)
| | - Ned H Kalin
- Department of Psychiatry, New York University School of Medicine, New York (Reiff); Department of Psychiatry and Human Behavior, Emory University School of Medicine, Atlanta (Richman, McDonald); Department of Psychiatry, Dell Medical School and the Institute for Early Life Adversity Research, University of Texas at Austin (Nemeroff); Department of Psychiatry and Human Behavior, Butler Hospital, Brown University, Providence, R.I. (Carpenter); Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis (Widge); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, Calif., and Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Rodriguez); Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison (Kalin)
| | - William M McDonald
- Department of Psychiatry, New York University School of Medicine, New York (Reiff); Department of Psychiatry and Human Behavior, Emory University School of Medicine, Atlanta (Richman, McDonald); Department of Psychiatry, Dell Medical School and the Institute for Early Life Adversity Research, University of Texas at Austin (Nemeroff); Department of Psychiatry and Human Behavior, Butler Hospital, Brown University, Providence, R.I. (Carpenter); Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis (Widge); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, Calif., and Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Rodriguez); Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison (Kalin)
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- Department of Psychiatry, New York University School of Medicine, New York (Reiff); Department of Psychiatry and Human Behavior, Emory University School of Medicine, Atlanta (Richman, McDonald); Department of Psychiatry, Dell Medical School and the Institute for Early Life Adversity Research, University of Texas at Austin (Nemeroff); Department of Psychiatry and Human Behavior, Butler Hospital, Brown University, Providence, R.I. (Carpenter); Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis (Widge); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, Calif., and Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Rodriguez); Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison (Kalin)
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Palma-Álvarez RF, Grau-López L, Ros-Cucurull E, Abad AC, Dualde J, Robles-Martínez M, Roncero C. Psychosis induced by abuse of ayahuasca: a case report. ACTA ACUST UNITED AC 2020; 50:43-46. [PMID: 33648696 DOI: 10.1016/j.rcp.2019.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 10/28/2019] [Indexed: 10/25/2022]
Abstract
Ayahuasca is a psychotropic infusion prepared by boiling the bark of Amazonian plants and has many psychopharmacological effects not fully understood. Some of those effects are used as treatment for different diseases. However, the side effects of ayahuasca, including ayahuasca-induced psychosis, are an important issue. Here we report the case of a patient who had a psychotic episode after taking ayahuasca and who was successfully treated with antipsychotic medication. Given the current spread of ayahuasca consumption in developed societies, the present case highlights the need for better understanding and regulation of the social-legal condition of ayahuasca and the need for further research. Additionally, psycho-education seems advisable in order to create awareness of the potential risks of the use of ayahuasca.
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Affiliation(s)
- Raul Felipe Palma-Álvarez
- Addiction and Dual Diagnosis Unit, Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Lara Grau-López
- Addiction and Dual Diagnosis Unit, Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain
| | - Elena Ros-Cucurull
- Addiction and Dual Diagnosis Unit, Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain
| | - Alfonso Carlos Abad
- Addiction and Dual Diagnosis Unit, Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | - Julia Dualde
- Psychiatry Department, Hospital San Rafael-Germanes Hospitalàries, Barcelona, Spain
| | | | - Carlos Roncero
- Psychiatric Service, University of Salamanca Health Care Complex; Psychiatric Department, University of Salamanca, Salamanca, Spain.
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